Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1178336 | TX |
NPI | 1003184334 |
---|---|
Provider Name | Erin Gonzalez |
First Address | Pearland, TX 77584-5233 |
Second Address | Pearland, TX 77584-5233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2011 |
Last Update Date | 16/07/2012 |