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NPI Code Detail

MEDICARE: PEDRO DANIEL GONZALEZ M.D.

MEDICARE:   PEDRO DANIEL GONZALEZ  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
1207QS1201XSleep Medicine (Family Medicine) PhysicianK8628TX
2207Q00000XFamily Medicine PhysicianK8628TX

Other Identifiers

General Provider Information

NPI Number : 1609846682
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEDRO DANIEL GONZALEZ M.D.
Provider Business Mailing Address
First Line : 141 INDUSTRIAL AVE
Second Line :
City : AZLE
State : TX
Zip : 76020-2901
Country : US
Telephone Number : 817-444-3231
Fax Number : 817-444-3234
Provider Business Practice Location Address
First Line : 141 INDUSTRIAL AVE
Second Line :
City : AZLE
State : TX
Zip : 76020-2901
Country : US
Telephone Number : 817-444-3231
Fax Number : 817-444-3234
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2006
Last Update Date : 04/12/2022

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Directions to “ PEDRO DANIEL GONZALEZ M.D.” Practice Location

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