MEDICARE: GABRIEL B GONZALEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	MD452910	PA
2	207V00000X	Obstetrics & Gynecology Physician	T3287	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245468396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIEL B GONZALEZ MD

Provider Business Mailing Address
First Line	:	PO BOX 846098
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-6098
Country	:	US
Telephone Number	:	903-324-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	18707 HARDY OAK BLVD STE 230
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4890
Country	:	US
Telephone Number	:	210-494-2000
Fax Number	:	210-494-6119

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2009
Last Update Date	:	05/26/2023

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