Provider Demographics
NPI:1568623890
Name:GONZALES, GONZALO JR (DO)
Entity Type:Individual
Prefix:DR
First Name:GONZALO
Middle Name:
Last Name:GONZALES
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6020 W PARKER RD STE 300
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8177
Mailing Address - Country:US
Mailing Address - Phone:469-925-3133
Mailing Address - Fax:972-942-0102
Practice Address - Street 1:6020 W PARKER RD STE 300
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8177
Practice Address - Country:US
Practice Address - Phone:469-925-3133
Practice Address - Fax:972-942-0102
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN63192081P2900X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine