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General NPI Number Information
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NPI Number | 1083989768
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Entity Type | Individual
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Provider Name | ABIEL E. GONZALEZ III D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/14/2012
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 5920 W WILLIAM CANNON BLDG 1, SUITE 100
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City | AUSTIN
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State | TX
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Zip | 78749-1902
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Country | US
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Telephone | 512-302-4773
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Fax | 512-302-1678
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Provider Business Mailing Address
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Address Line | 1929 PAYTON GIN RD
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City | AUSTIN
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State | TX
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Zip | 78757-8501
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Country | US
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Telephone | 512-302-4773
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Fax | 512-302-1678
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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 | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 12024
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License Number State | TX
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