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General NPI Number Information
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NPI Number | 1629465513
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Entity Type | Individual
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Provider Name | TITO A GONZALEZ ANGELI DMD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2015
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 1354 W 43RD ST STE C
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City | HOUSTON
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State | TX
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Zip | 77018-4206
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Country | US
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Telephone | 713-263-7913
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Fax |
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Provider Business Mailing Address
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Address Line | 3508 VISTA TERRACE LN
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City | HOUSTON
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State | TX
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Zip | 77018-2508
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Country | US
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Telephone | 787-908-2230
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 32439
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 32429
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License Number State | TX
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