Individual
CHARLES GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12380 DE PAUL DR, BRIDGETON, MO 63044-2511
(877) 749-7428
(512) 628-3314
Mailing address
1776 WOODSTEAD CT, STE 208, THE WOODLANDS, TX 77380-1480
(563) 359-6786
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2018015039
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200057629
—
MO
Enumeration date
04/29/2014
Last updated
11/07/2025
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