Provider Demographics
NPI:1669465712
Name:GONZALEZ, JESUS E (DC)
Entity Type:Individual
Prefix:DR
First Name:JESUS
Middle Name:E
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10988 FUQUA ST.
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089
Mailing Address - Country:US
Mailing Address - Phone:281-464-0118
Mailing Address - Fax:281-464-0119
Practice Address - Street 1:10988 FUQUA ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-2410
Practice Address - Country:US
Practice Address - Phone:281-464-0118
Practice Address - Fax:281-464-0119
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2008-01-02
Deactivation Date:2006-03-27
Deactivation Code:
Reactivation Date:2006-03-30
Provider Licenses
StateLicense IDTaxonomies
TX6863111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor