Gomez-Diaz, Suzanne M

Gomez-Diaz, Suzanne M is an individual health care provider with primary practice located at 818 N 4Th St , Longview TX 95601. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Gomez-Diaz, Suzanne M can be contacted via phone (903) 236-8600.

Contact Information

Primary practice address
818 N 4Th St Longview TX 95601
Phone: (903) 236-8600
Fax: (903) 236-8605
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A73474 California
Allopathic & Osteopathic Physicians / Pediatrics 208000000X L4954 Texas

Profile Details

NPI number 1043284375
LBN Legal business name Gomez-Diaz, Suzanne M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated Nov 8th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043284375 NPPES
Texas MEDICAID 153840702
Texas MEDICAID 153840701

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