MARIO GABRIEL GONZALEZ MD NPI 1669591871

NPI Information

NPI: 1669591871
Provider Name: MARIO GABRIEL GONZALEZ, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Organization: ODETTE LOUISE CAMPBELL, MD, PA

PECOS Registration: Yes

Address:
855 MONTGOMERY
FORT WORTH, TX
ZIP 76107
Phone: (817) 920-7000
Get Directions

Mario Gabriel Gonzalez, MD is a family medicine in Fort Worth, TX with 20 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Mario Gabriel Gonzalez, MD NPI is 1669591871. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

855 MONTGOMERY
FORT WORTH, TX
ZIP 76107-553
Phone: (817) 920-7000

The NPI 1669591871 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/28/2007 and was last updated on 12/23/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		P4959	TEXAS	Yes
2	207QA0505X	Family Medicine	Adult Medicine	MD-2007-0108	NEW MEXICO	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P01379265	OTHER	TEXAS	RAILROAD MEDICARE
2	329998401	MEDICAID	TEXAS
3	333381YPF6	MEDICARE PIN	TEXAS
4	8EE670	OTHER	TEXAS	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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