Provider Demographics
NPI:1063255768
Name:GOMEZ, ASHLEY (PT DPT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 FAIRFAX ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7710
Mailing Address - Country:US
Mailing Address - Phone:956-346-8321
Mailing Address - Fax:
Practice Address - Street 1:900 CAMELOT DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8416
Practice Address - Country:US
Practice Address - Phone:956-395-1430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist