# SPORTS CONCUSSION TREATMENT CENTER OF TEXAS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578950333
- **Authorized official:** DR. JOHN GUSTAVO GOMEZ M.D. (MANAGING PARTNER)
- **Authorized official phone:** (940) 231-1129

## Contact information

- **Practice address:** 2940 FM 407, SUITE 302, HIGHLAND VILLAGE, TX 75077-7045
- **Practice address phone:** (972) 316-9011
- **Mailing address:** 2940 FM 407, SUITE 302, HIGHLAND VILLAGE, TX 75077-7045
- **Mailing address phone:** (972) 316-9011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | L1055 | TX | Yes |

## Other

- **Enumeration date:** 04/20/2015
- **Last updated:** 04/20/2015