Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | AP133346 | TX |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP133346 | TX |
NPI | 1245779495 |
---|---|
Provider Name | Jessica Ann Gomez |
First Address | Pearland, TX 77584-8148 |
Second Address | Houston, TX 77030-1501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2017 |
Last Update Date | 21/02/2017 |