MEDICARE: DR. GONZALO JULIO PERLA D.C.

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	111N00000X	Chiropractor	CH60418787	WA
2	111N00000X	Chiropractor	15130	TX

General Provider Information

NPI Number	:	1588094817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GONZALO JULIO PERLA D.C.

Provider Business Mailing Address
First Line	:	14755 NORTH FWY STE 400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-6508
Country	:	US
Telephone Number	:	281-876-2500
Fax Number	:	281-876-2574

Provider Business Practice Location Address
First Line	:	14755 NORTH FWY STE 400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-6508
Country	:	US
Telephone Number	:	281-876-2500
Fax Number	:	281-876-2574

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

Provider Enumeration Date	:	11/22/2013
Last Update Date	:	04/03/2024

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