Provider Demographics
NPI:1689400368
Name:GOMEZ, FRANCISCO R
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:R
Last Name:GOMEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5427 E MADERA STREET
Mailing Address - Street 2:BLDG 4339
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85708
Mailing Address - Country:US
Mailing Address - Phone:520-228-5507
Mailing Address - Fax:
Practice Address - Street 1:5427 E MADERA STREET
Practice Address - Street 2:BLDG 4339
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85708
Practice Address - Country:US
Practice Address - Phone:520-228-5507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2650101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)