Individual
DR. LORI MICHELLE GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1000 SAN JACINTO MALL, (SEARS BLDG.), BAYTOWN, TX 77521-8355
(281) 421-5280
Mailing address
8630 TARTAN WALK LN, HOUSTON, TX 77075-4824
(713) 991-3697
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
06584TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06584TG
STATE LICENSE NUMBER
TX
01
—
A0140255
DPS REGISTRATION NUMBER
TX
Enumeration date
04/17/2007
Last updated
07/08/2007
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