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NPI Code Detail

MEDICARE: DR. CHAD RYAN GONCZY M.D.

MEDICARE: DR. CHAD RYAN GONCZY M.D.
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
12086X0206XSurgical Oncology PhysicianMD461691PA
22086X0206XSurgical Oncology PhysicianW5800TX
3208600000XSurgery Physician036145851IL

General Provider Information

NPI Number : 1487965356
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHAD RYAN GONCZY M.D.
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number : 800-994-0371
Fax Number : 254-215-9722
Provider Business Practice Location Address
First Line : 300 UNIVERSITY BLVD
Second Line :
City : ROUND ROCK
State : TX
Zip : 78665-1032
Country : US
Telephone Number : 512-509-0100
Fax Number : 512-509-2137
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2010
Last Update Date : 06/16/2026

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