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General NPI Number Information
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NPI Number | 1225916513
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Entity Type | Individual
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Provider Name | JONATHAN TYLER GONZALEZ DPT
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Gender | Male
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 1111 HIGHWAY 6 STE 195
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City | SUGAR LAND
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State | TX
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Zip | 77478-4959
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Country | US
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Telephone | 832-658-3205
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Fax |
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Provider Business Mailing Address
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Address Line | 7100 OLD KATY RD APT 2307
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City | HOUSTON
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State | TX
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Zip | 77024-2291
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Country | US
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Telephone |
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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 | 1382441
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License Number State | TX
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