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Individual
MARIO GABRIEL GONZALEZ
Active
Individual
MARIO GABRIEL GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
P4959
TX
207QA0505X
Adult Medicine Physician
MD-2007-0108
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
329998401
—
TX
01
—
8EE670
BCBS
TX
01
—
P01379265
RAILROAD MEDICARE
TX
Enumeration date
03/28/2007
Last updated
12/23/2014
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