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Individual
MAE P. GONZALES
Active
Individual
MAE P. GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J2946
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080183432
RAILROAD MEDICARE
TX
05
—
127671904
—
TX
05
—
127671909
—
TX
05
—
127671911
—
TX
05
—
127671913
—
TX
05
—
127671914
—
TX
05
—
127671915
—
TX
05
—
127671917
—
TX
05
—
127671918
—
TX
05
—
127671920
—
TX
05
—
127671921
—
TX
05
—
127671923
—
TX
05
—
127671924
—
TX
05
—
127671925
—
TX
05
—
127671926
—
TX
05
—
127671927
—
TX
05
—
127671928
—
TX
05
—
127671930
—
TX
05
—
127671931
—
TX
05
—
127671932
—
TX
05
—
127671933
—
TX
05
—
127671934
—
TX
05
—
127671936
—
TX
01
—
8743J8
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/15/2005
Last updated
01/23/2013
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