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General NPI Number Information
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NPI Number | 1669782579
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Entity Type | Individual
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Provider Name | DAVID LLOYD GONZALES DDS
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Gender | Male
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Dates
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Enumeration Date | 10/13/2010
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 4151 SOUTHWEST FWY STE 130
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City | HOUSTON
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State | TX
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Zip | 77027-0001
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Country | US
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Telephone | 713-829-5508
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Fax | 713-583-6961
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Provider Business Mailing Address
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Address Line | 720 PASADENA BLVD
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City | PASADENA
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State | TX
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Zip | 77506-5334
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Country | US
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Telephone | 713-473-3163
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 17279
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License Number State | TX
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