MS. STASHA C GOMINAK MD NPI 1659486116

NPI Information

  • NPI: 1659486116
  • Provider Name: MS. STASHA C GOMINAK, MD
  • Classification: Psychiatry & Neurology - 2084N0400X
  • Specialization: Neurology
  • Entity Type: Individual
  • Address: 700 OLYMPIC PLAZA CIR
    STE 912
    TYLER, TX
    ZIP 75701
  • Phone: (903) 596-3808

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NPI Details

MS. Stasha C Gominak, MD is a neurology psychiatry neurology in Tyler, TX. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. MS. Stasha C Gominak, MD NPI is 1659486116. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

700 OLYMPIC PLAZA CIR
STE 912
TYLER, TX
ZIP 75701-951
Phone: (903) 596-3808
Fax: (903) 596-3815

The enumeration date for this NPI number is 8/21/2006 and was last updated on 7/30/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084N0400XPsychiatry & NeurologyNeurologyG5098TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18K7990OTHERTEXASBCBS
28B5358MEDICARE ID-TYPE UNSPECIFIEDTEXAS
3164215901MEDICAIDTEXAS
4F06513MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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