MEDICARE: DR. LUIS E 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	207R00000X	Internal Medicine Physician	G3399	TX

General Provider Information

NPI Number	:	1932186251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIS E GONZALEZ M.D

Provider Business Mailing Address
First Line	:	7520 FM 3180 RD STE 500
Second Line	:
City	:	BAYTOWN
State	:	TX
Zip	:	77523-5007
Country	:	US
Telephone Number	:	832-808-7095
Fax Number	:	832-327-7633

Provider Business Practice Location Address
First Line	:	7520 FM 3180 RD STE 500
Second Line	:
City	:	BAYTOWN
State	:	TX
Zip	:	77523-5007
Country	:	US
Telephone Number	:	832-808-7095
Fax Number	:	832-327-7633

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	01/20/2025

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