| Doctor Name: | MR. ROBERTO GOMEZ |
| NPI Number: | 1649509464 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1514 Banker Rd Canutillo, TX - 798358955 |
| Business Phone Number: | 9152562685 |
| Business Fax Number: | 9155032138 |
| Mailing Address: | 1514 Banker Rd, CANUTILLO |
| State: | TX |
| Postal Code: | 798358955 |
| Phone Number: | 9152562685 |
| Fax Number: | 9155032138 |
| NPI Enumeration Date: | 12/08/2009 |
| NPI Last Update Date: | 12/08/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041S0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |