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General NPI Number Information
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NPI Number | 1598790644
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Entity Type | Individual
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Provider Name | GONZALO A. AILLON II D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 10/08/2019
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Provider Practice Location Address
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Address Line | 1401 S RANGERVILLE RD
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City | HARLINGEN
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State | TX
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Zip | 78552-7638
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Country | US
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Telephone | 956-430-2408
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Fax |
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Provider Business Mailing Address
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Address Line | 1138 BRADLEY DR
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City | DUNCANVILLE
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State | TX
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Zip | 75137-4224
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Country | US
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Telephone | 214-536-3355
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Fax | 972-572-2258
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | L2781
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License Number State | TX
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