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General NPI Number Information
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NPI Number | 1316865736
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Entity Type | Individual
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Provider Name | CHRISTIAN M GONZALEZ
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Gender | Male
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 8600 N RIVERSIDE DR
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City | FORT WORTH
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State | TX
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Zip | 76244-9634
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Country | US
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Telephone | 847-441-5593
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Fax |
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Provider Business Mailing Address
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Address Line | 853 ROYAL BURCH LN
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City | FORT WORTH
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State | TX
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Zip | 76131-4383
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Country | US
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Telephone | 310-800-7090
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2175794
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License Number State | TX
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