Provider Demographics
NPI:1578505772
Name:GOMEZ, HECTOR L (MD)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:L
Last Name:GOMEZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:20403 ENCINO LEDGE UNIT 592716
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-0873
Mailing Address - Country:US
Mailing Address - Phone:210-927-1832
Mailing Address - Fax:210-927-3426
Practice Address - Street 1:111 DALLAS ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1201
Practice Address - Country:US
Practice Address - Phone:210-927-1832
Practice Address - Fax:210-927-3426
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9556207RP1001X
TXN7619207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX280115102Medicaid
NV002018327Medicaid
NV34898Medicare ID - Type Unspecified