Provider Demographics
NPI:1992929897
Name:GONZALEZ, ANGELA ELOINA (DDS)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:ELOINA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:251 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4242
Mailing Address - Country:US
Mailing Address - Phone:281-316-8900
Mailing Address - Fax:281-316-8945
Practice Address - Street 1:251 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4242
Practice Address - Country:US
Practice Address - Phone:281-316-8900
Practice Address - Fax:281-316-8945
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX169051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice