Individual
ALFONSO IVAN GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 BERNICE AVE, ODESSA, TX 79763-4226
(432) 333-1300
(432) 333-1306
Mailing address
501 BERNICE AVE, ODESSA, TX 79763-4226
(432) 333-1300
(432) 333-1306
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
M3815
TX
207P00000X
Emergency Medicine Physician
MD2005-0515
NM
207Q00000X
Family Medicine Physician
Primary
M3815
TX
207Q00000X
Family Medicine Physician
MD2005-0515
NM
Other
Enumeration date
04/03/2006
Last updated
12/31/2018
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