Individual
DR. AGUSTIN L GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
811 N CENTRAL EXPY, SUITE 1000, PLANO, TX 75075-8815
(972) 423-3937
Mailing address
3503 WILLOWBROOK DR, RICHARDSON, TX 75082-2411
(972) 235-3185
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4044
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18FC
BCBS
TX
01
—
7828209
AETNA
—
01
—
9262207
PHCS
—
Enumeration date
02/23/2006
Last updated
08/30/2013
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