Provider Demographics
NPI:1982084810
Name:GOMEZ ROMERO, ANGELA ANDREA (DDS)
Entity type:Individual
Prefix:DR
First Name:ANGELA ANDREA
Middle Name:
Last Name:GOMEZ ROMERO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18015 CAMINO DEL MAR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-5002
Mailing Address - Country:US
Mailing Address - Phone:208-724-3277
Mailing Address - Fax:
Practice Address - Street 1:11919 CULEBRA RD BLDG 2
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-2102
Practice Address - Country:US
Practice Address - Phone:210-688-0332
Practice Address - Fax:210-688-0333
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401414846122300000X
TX37042122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist