Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 1142 | TX |
N | 222Z00000X | Podiatrist | 1142 | TX |
Y | 224P00000X | Prosthetist | 1142 | TX |
NPI | 1326692351 |
---|---|
Provider Name | Mr. Steven Gomez Herrera SR. |
First Address | San Antonio, TX 78229-6000 |
Second Address | San Antonio, TX 78229-6000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2019 |
Last Update Date | 25/05/2021 |