Provider Demographics
NPI:1124788344
Name:GONZALEZ, EZEQUIEL JR (DC)
Entity type:Individual
Prefix:DR
First Name:EZEQUIEL
Middle Name:
Last Name:GONZALEZ
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 W DOVE LN APT 101
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-1184
Mailing Address - Country:US
Mailing Address - Phone:956-222-7513
Mailing Address - Fax:
Practice Address - Street 1:900 W CENTRAL TEXAS EXPY
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-2566
Practice Address - Country:US
Practice Address - Phone:254-634-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14976111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor