Provider Demographics
NPI:1861967697
Name:GOMEZ, SANIDA MICHELLE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:SANIDA
Middle Name:MICHELLE
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 734063
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-4063
Mailing Address - Country:US
Mailing Address - Phone:281-888-8999
Mailing Address - Fax:281-305-4054
Practice Address - Street 1:1908 N LAURENT ST STE 120
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-7790
Practice Address - Country:US
Practice Address - Phone:281-888-8999
Practice Address - Fax:281-305-4054
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139131363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily