Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 12024 | TX |
NPI | 1083989768 |
---|---|
Provider Name | Dr. Abiel E. Gonzalez III |
First Address | The Woodlands, TX 77380-2287 |
Second Address | The Woodlands, TX 77380-2287 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2012 |
Last Update Date | 14/03/2012 |