Provider Demographics
NPI:1679797021
Name:ERICK GONZALEZ, PSY.D. PLLC
Entity Type:Organization
Organization Name:ERICK GONZALEZ, PSY.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:972-727-3627
Mailing Address - Street 1:400 N ALLEN DR STE 208
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-2570
Mailing Address - Country:US
Mailing Address - Phone:972-727-3627
Mailing Address - Fax:972-390-2302
Practice Address - Street 1:400 N ALLEN DR STE 208
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2570
Practice Address - Country:US
Practice Address - Phone:972-727-3627
Practice Address - Fax:972-390-2302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31529103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX31529OtherTX STATE PSYCHOLOGIST