Individual
STEVAN A GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1250 8TH AVE, SUITE 515, FORT WORTH, TX 76104-4124
(817) 922-4675
(817) 922-4645
Mailing address
1250 8TH AVE, SUITE 515, FORT WORTH, TX 76104-4124
(817) 922-4675
(817) 922-4645
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M9319
TX
207RG0100X
Gastroenterology Physician
M9319
TX
207RI0008X
Hepatology Physician
M9319
TX
207RT0003X
Transplant Hepatology Physician
Primary
M9319
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194435701
—
TX
05
—
194435702
—
TX
05
—
194435703
—
TX
01
—
8X0059
BCBS
TX
Enumeration date
05/10/2008
Last updated
05/24/2022
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