Provider Demographics
NPI:1285420851
Name:GOMEZ, ANGEL ANN (RN)
Entity type:Individual
Prefix:MS
First Name:ANGEL
Middle Name:ANN
Last Name:GOMEZ
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13402 MAGNOLIA CREST LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-3453
Mailing Address - Country:US
Mailing Address - Phone:806-438-6248
Mailing Address - Fax:
Practice Address - Street 1:13402 MAGNOLIA CREST LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-3453
Practice Address - Country:US
Practice Address - Phone:806-438-6248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX952929163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX08621888OtherTEXAS DRIVERS LICENSE NBR