Individual
PROF. RICHARD H GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CP, LPO
Contact information
Practice address
407 N 4TH ST, LONGVIEW, TX 75601-6512
(903) 241-0675
(903) 234-0248
Mailing address
407 N 4TH ST, LONGVIEW, TX 75601-6512
(903) 241-0675
(903) 234-0248
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
131
TX
224P00000X
Prosthetist
131
TX
224P00000X
Prosthetist
Primary
CP001022
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
69606542
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/09/2007
Last updated
09/11/2025
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