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General NPI Number Information
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NPI Number | 1952737371
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Entity Type | Organization
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Legal Business Name | ERNEST A GONZALEZ MD PA
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Dates
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Enumeration Date | 09/17/2013
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Last Update Date | 06/27/2014
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Provider Practice Location Address
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Address Line | 12319 N MOPAC EXPY STE 350
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City | AUSTIN
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State | TX
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Zip | 78758-2512
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Country | US
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Telephone | 512-491-6542
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Fax | 512-491-0161
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Provider Business Mailing Address
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Address Line | PO BOX 26303
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City | OKLAHOMA CITY
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State | OK
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Zip | 73126-0303
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Country | US
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Telephone | 512-491-6542
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Fax | 512-491-0161
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ERNEST A GONZALEZ
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Credential |
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Telephone | 512-491-6542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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