Provider Demographics
NPI:1922490507
Name:GONZALEZ, LESLIE CLAIRE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:CLAIRE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:LESLIE
Other - Middle Name:CLAIRE
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13150 FM 529 RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-2570
Mailing Address - Country:US
Mailing Address - Phone:713-896-1815
Mailing Address - Fax:713-896-1853
Practice Address - Street 1:13150 FM 529 RD
Practice Address - Street 2:SUITE 114
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-2570
Practice Address - Country:US
Practice Address - Phone:713-896-1815
Practice Address - Fax:713-896-1853
Is Sole Proprietor?:No
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12460792251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics