MEDICARE: ARIEL DEMI GONZALES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1558045955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIEL DEMI GONZALES

Provider Business Mailing Address
First Line	:	1301 ANTOINE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-6942
Country	:	US
Telephone Number	:	361-222-3254
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 YALE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-6923
Country	:	US
Telephone Number	:	832-713-6830
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2023
Last Update Date	:	01/06/2025

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Directions to “ ARIEL DEMI GONZALES ” Practice Location

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