Provider Demographics
NPI:1588094817
Name:PERLA, GONZALO JULIO (DC)
Entity type:Individual
Prefix:DR
First Name:GONZALO
Middle Name:JULIO
Last Name:PERLA
Suffix:
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 1:14755 NORTH FWY STE 400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-6508
Mailing Address - Country:US
Mailing Address - Phone:281-876-2500
Mailing Address - Fax:281-876-2574
Practice Address - Street 1:14755 NORTH FWY STE 400
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-6508
Practice Address - Country:US
Practice Address - Phone:281-876-2500
Practice Address - Fax:281-876-2574
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60418787111N00000X
TX15130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor