Gonzalez, Juan Fernando
Gonzalez, Juan Fernando is an sole proprietor health care provider with primary practice located at 4010 Sandy Brook Dr Ste 204 , Round Rock TX 78665-1518. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Gonzalez, Juan Fernando can be contacted via phone (512) 375-0050.Contact Information
Primary practice address
4010 Sandy Brook Dr Ste 204
Round Rock TX 78665-1518
Phone: (512) 375-0050
Fax: (512) 682-9009
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 22953 | Texas |
Profile Details
| NPI number | 1073575130 |
|---|---|
| LBN Legal business name | Gonzalez, Juan Fernando |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 4th, 2006 |
| Last updated | Dec 23rd, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073575130 | NPPES |
| Texas | MEDICAID | 218656102 | |
| Texas | Other | 22953 |
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