Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | M3237 | TX |
Y | 208800000X | Urologist | M3237 | TX |
NPI | 1629020292 |
---|---|
Provider Name | Ricardo R Gonzalez |
First Address | Houston, TX 77030-2769 |
Second Address | Houston, TX 77030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 18/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
393690801 | (05) | TX |
I37211 | (02) | TX |