Doctor Name: | BRIAN ANTONIO GOMEZ |
NPI Number: | 1245453299 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 60798 |
Business Practice Address: | 2483 Britt Dr Argyle, TX - 762262994 |
Business Phone Number: | 2147632589 |
Business Fax Number: | |
Mailing Address: | Po Box 511, ROCKWALL |
State: | TX |
Postal Code: | 750870511 |
Phone Number: | 2147632589 |
Fax Number: | |
NPI Enumeration Date: | 04/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 60798 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |