Individual
DAVID T GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4201 CAMP BOWIE BLVD, FORT WORTH, TX 76107-3928
(817) 731-0801
(817) 731-8468
Mailing address
1015 S JENNINGS AVE APT 1200, FORT WORTH, TX 76104-3265
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02815
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287991801
—
TX
Enumeration date
09/05/2006
Last updated
01/08/2015
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