MEDICARE: MS. SYLVIA GONZALEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	M7221	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00761750	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8BN510	OTHER	TX	BLUE CROSS BLUE SHIELD OF TEXAS

General Provider Information

NPI Number	:	1114115078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SYLVIA GONZALEZ M.D.

Provider Business Mailing Address
First Line	:	6560 FANNIN ST STE 1878
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2752
Country	:	US
Telephone Number	:	713-441-3800
Fax Number	:	713-793-1015

Provider Business Practice Location Address
First Line	:	6560 FANNIN ST STE 1878
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2752
Country	:	US
Telephone Number	:	713-441-3800
Fax Number	:	713-793-1015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2007
Last Update Date	:	03/23/2011

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