Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 312 OP2312 | NM |
NPI | 1003992199 |
---|---|
Provider Name | Dr. Paul Alan Gomez |
First Address | Las Cruces, NM 88011-8035 |
Second Address | Las Cruces, NM 88001-5402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 08/07/2007 |