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NPI Code Detail

MEDICARE: RODOLFO GONZALEZ

MEDICARE: RODOLFO GONZALEZ
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
1225100000XPhysical Therapist1081206TX

General Provider Information

NPI Number : 1851503502
Entity Type Code : Individual
Provider Name (Legal Business Name) : RODOLFO GONZALEZ
Provider Business Mailing Address
First Line : 87 ORIEL OAKS CIRCLE
Second Line :
City : THE WOODLANDS
State : TX
Zip : 77382
Country : US
Telephone Number : 832-647-9453
Fax Number :
Provider Business Practice Location Address
First Line : 6200 N BRAESWOOD BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77074-7536
Country : US
Telephone Number : 713-776-3654
Fax Number : 713-776-3659
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2007
Last Update Date : 07/08/2007

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Directions to “ RODOLFO GONZALEZ ” Practice Location

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