Healthcare Provider Details

I. General information

NPI: 1841231446
Provider Name (Legal Business Name): VIRGINIA YOLANDA GONZALEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18780 INTERSTATE 20
CANTON TX
75103-3593
US

IV. Provider business mailing address

2595 DALLAS PKWY SUITE 405
FRISCO TX
75034-8527
US

V. Phone/Fax

Practice location:
  • Phone: 903-567-4841
  • Fax:
Mailing address:
  • Phone: 972-377-1490
  • Fax: 972-377-1499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.168994
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35C.000812
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA070362
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number94347
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberEMC0004740
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25IA12140500
License Number StateNJ
# 7
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD61391231
License Number StateWA
# 8
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number73045
License Number StateAZ
# 9
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM4997
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: