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General NPI Number Information
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NPI Number | 1023052164
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Entity Type | Individual
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Provider Name | GONZALO URIBEBOTERO MD
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Gender | Male
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 6575 WEST LOOP S
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City | BELLAIRE
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State | TX
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Zip | 77401-3521
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Country | US
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Telephone | 713-779-1633
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Fax | 713-995-5914
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Provider Business Mailing Address
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Address Line | 6575 WEST LOOP S
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City | BELLAIRE
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State | TX
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Zip | 77401-3521
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Country | US
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Telephone | 713-779-1633
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Fax | 713-995-5914
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | E1956
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | E1956
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E1956
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License Number State | TX
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