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Organization
ALFONSO I GONZALEZ MD PA
Active
Organization
ALFONSO I GONZALEZ MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFONSO I GONZALEZ M.D. (PHYSICIAN)
(432) 333-1300
Entity
Organization
Contact information
Practice address
500 N WASHINGTON AVE, STE 600, ODESSA, TX 79761-4401
(432) 333-1300
(432) 333-1306
Mailing address
500 N WASHINGTON AVE, STE 600, ODESSA, TX 79761-4401
(432) 333-1300
(432) 333-1306
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
M3815
TX
207Q00000X
Family Medicine Physician
Primary
M3815
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8W7325
BLUE CROSS
TX
Enumeration date
06/02/2008
Last updated
08/04/2008
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