Organization
ADNOGON SPORTS MEDICINE
Active
Other names
City Chiro Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME LEONARDO GONZALEZ D.C, C.C.S.P. (OWNER)
(214) 335-3947
Entity
Organization
Contact information
Practice address
2500 LAKESIDE PKWY STE 120, FLOWER MOUND, TX 75022-4254
(214) 285-8774
(972) 316-9245
Mailing address
2500 LAKESIDE PKWY STE 120, FLOWER MOUND, TX 75022-4254
(214) 285-8774
(972) 316-9245
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356489900
INDIVIDUAL NPI
TX
Enumeration date
05/12/2021
Last updated
05/12/2021
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