Stevan A Gonzalez
Internist Gastroenterologist
1250 8th Ave Suite 515
Fort Worth
, Texas 76104-4124
Stevan A Gonzalez
Internist Gastroenterologist
1250 8th Ave Suite 515
Fort Worth
, Texas 76104-4124
(817) 922-4645
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About
Features
Specialties
- Internist
- Gastroenterologist
Languages spoken
- English
Location
First Address
- Stevan A Gonzalez
- 1250 8th Ave Suite 515
- Fort Worth, TX
- Zip : 76104-4124
- Fax : (817) 922-4645
- Phone : (817) 922-4675
Second Address
- Stevan A Gonzalez
- 1250 8th Ave Suite 515
- Fort Worth, TX
- Zip : 76104-4124
- Fax : (817) 922-4645
- Phone : (817) 922-4675
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207R00000X | Internist | M9319 | TX |
| N | 111NI0900X | Internist | M9319 | TX |
| Y | 207RG0100X | Gastroenterologist | M9319 | TX |
National Provider Identifier
| NPI | 1013184985 |
|---|---|
| Provider Name | Stevan A Gonzalez |
| First Address | Fort Worth, TX 76104-4124 |
| Second Address | Fort Worth, TX 76104-4124 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/05/2008 |
| Last Update Date | 29/07/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 194435701 | (05) | TX |
| 194435702 | (05) | TX |
| 194435703 | (05) | TX |
| 8X0059 | BCBS (01) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.