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NPI Code Detail

MEDICARE: NARCISO GONZALEZ MD PLLC

MEDICARE: NARCISO GONZALEZ MD PLLC
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
1204R00000XElectrodiagnostic Medicine Physician

General Provider Information

NPI Number : 1952889198
Entity Type Code : Organization
Provider Name (Legal Business Name) : NARCISO GONZALEZ MD PLLC
Provider Business Mailing Address
First Line : PO BOX 104
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78291-0104
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 111 BOLAND ST STE 211
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-1265
Country : US
Telephone Number : 214-269-3875
Fax Number : 903-328-6568
Authorized Official
Title or Position : BILLING MANAGER
Name : GINA SULLIVAN
Credential :
Telephone Number : 214-269-3875
Provider Enumeration Date : 07/31/2018
Last Update Date : 11/28/2018

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