Provider Demographics
NPI:1174528319
Name:CURLL, MARY GOMEZ (RN, FNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:GOMEZ
Last Name:CURLL
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1730 FAWN GATE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-1325
Mailing Address - Country:US
Mailing Address - Phone:210-492-7278
Mailing Address - Fax:210-479-2626
Practice Address - Street 1:1025 S PRESA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78210-1359
Practice Address - Country:US
Practice Address - Phone:210-228-9340
Practice Address - Fax:210-228-9342
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX500273363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXNP0422Medicare PIN