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General NPI Number Information
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NPI Number | 1043984438
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Entity Type | Individual
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Provider Name | ELY ANN GONZALEZ PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/09/2021
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Last Update Date | 08/09/2021
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Provider Practice Location Address
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Address Line | 18518 HARDY OAK BLVD STE 210
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4761
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Country | US
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Telephone | 210-545-5222
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Fax | 210-545-5225
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Provider Business Mailing Address
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Address Line | 5935 POLO CIR
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City | BULVERDE
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State | TX
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Zip | 78163-4159
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Country | US
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Telephone | 210-315-6177
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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