Gonzalez, Mario Gabriel

Gonzalez, Mario Gabriel is an individual health care provider with primary practice located at 855 Montgomery , Fort Worth TX 76107-2553. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Adult Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Gonzalez, Mario Gabriel can be contacted via phone (817) 920-7000.

Contact Information

Primary practice address
855 Montgomery Fort Worth TX 76107-2553
Phone: (817) 920-7000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X P4959 Texas
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X MD-2007-0108 New Mexico

Profile Details

NPI number 1669591871
LBN Legal business name Gonzalez, Mario Gabriel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2007
Last updated Dec 23rd, 2014 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669591871 NPPES
Texas Other P01379265 RAILROAD MEDICARE
Texas Other 8EE670 RAILROAD MEDICARE
Texas MEDICAID 329998401 RAILROAD MEDICARE

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