Provider Demographics
NPI:1659118461
Name:GOMEZ, DARLA (RDMS, RVT)
Entity type:Individual
Prefix:
First Name:DARLA
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:RDMS, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 TAYLOR OAKS DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76705-5423
Mailing Address - Country:US
Mailing Address - Phone:254-717-4110
Mailing Address - Fax:
Practice Address - Street 1:1105 N 5TH ST
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76707-3821
Practice Address - Country:US
Practice Address - Phone:254-307-1008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX812212085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound