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General NPI Number Information
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NPI Number | 1407009525
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Entity Type | Organization
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Legal Business Name | GILBERT GONZALES, JR, DC, PA, DBA SOUTH TEXAS CHIROPRACTIC PAIN CENTER
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Dates
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Enumeration Date | 11/03/2008
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Last Update Date | 11/03/2008
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Provider Practice Location Address
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Address Line | 1931 NW MILITARY HWY STE 204
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City | SAN ANTONIO
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State | TX
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Zip | 78213-2144
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Country | US
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Telephone | 210-541-8965
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Fax | 210-541-8964
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Provider Business Mailing Address
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Address Line | 1931 NW MILITARY HWY STE 204
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City | SAN ANTONIO
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State | TX
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Zip | 78213-2144
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Country | US
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Telephone | 210-541-8965
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Fax | 210-541-8964
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. GILBERT GONZALES JR.
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Credential | D.C.
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Telephone | 210-541-8965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 7403
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License Number State | TX
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