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General NPI Number Information
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NPI Number | 1215541347
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Entity Type | Individual
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Provider Name | JESUS GONZALEZ JR. RPH
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Gender | Male
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Dates
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Enumeration Date | 09/05/2020
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Last Update Date | 09/05/2020
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Provider Practice Location Address
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Address Line | 2619 RED BLUFF RD
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City | PASADENA
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State | TX
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Zip | 77506-5270
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Country | US
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Telephone | 713-475-0939
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Fax | 713-477-8514
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Provider Business Mailing Address
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Address Line | 1411 MAROBY ST
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City | HOUSTON
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State | TX
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Zip | 77017-4037
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Country | US
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Telephone | 713-649-8098
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 23986
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License Number State | TX
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