Healthcare Provider Details

I. General information

NPI: 1720213309
Provider Name (Legal Business Name): ANGELINE OPINA GONZALEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2009
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 CAMBRIDGE ST FL 6
HOUSTON TX
77030-4202
US

IV. Provider business mailing address

6621 FANNIN ST
HOUSTON TX
77030-2358
US

V. Phone/Fax

Practice location:
  • Phone: 713-798-2545
  • Fax:
Mailing address:
  • Phone: 832-826-2899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP7015
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RA0002X
TaxonomyAdult Congenital Heart Disease Physician
License NumberP7015
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP7015
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberP7015
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberP7015
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: