Provider Demographics
NPI:1528112075
Name:GONZALEZ, HUGO JR (DDS)
Entity type:Individual
Prefix:DR
First Name:HUGO
Middle Name:
Last Name:GONZALEZ
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 BELLAIRE BLVD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-4902
Mailing Address - Country:US
Mailing Address - Phone:713-771-1969
Mailing Address - Fax:713-771-9160
Practice Address - Street 1:6200 BELLAIRE BLVD
Practice Address - Street 2:SUITE #1
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-4902
Practice Address - Country:US
Practice Address - Phone:713-771-1969
Practice Address - Fax:713-771-9160
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15157122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1372901Medicare ID - Type Unspecified