Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | ME101837 | FL |
Y | 207L00000X | Anesthesiologist | N9557 | TX |
NPI | 1013163633 |
---|---|
Provider Name | Adolfo Gonzalez |
First Address | Dallas, TX 75235-7701 |
Second Address | Dallas, TX 75235-7701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2008 |
Last Update Date | 27/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2823759 01 | (05) | TX |