Provider Demographics
NPI:1730069832
Name:TOMBO, MARLENE GONZALES (PT)
Entity type:Individual
Prefix:
First Name:MARLENE
Middle Name:GONZALES
Last Name:TOMBO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1906 CREEKWAY DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-7566
Mailing Address - Country:US
Mailing Address - Phone:972-298-3398
Mailing Address - Fax:972-709-4090
Practice Address - Street 1:330 W CAMP WISDOM RD
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-3331
Practice Address - Country:US
Practice Address - Phone:972-298-3398
Practice Address - Fax:972-709-4090
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1068294208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty