Individual
DR. LUIS ANTONIO GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10400 VISTA DEL SOL DR STE 201, EL PASO, TX 79925-7924
(915) 594-1145
Mailing address
10400 VISTA DEL SOL DR STE 201, EL PASO, TX 79925-7924
(915) 594-1145
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
K4439
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031EJ
BC/BS
TX
Enumeration date
05/12/2006
Last updated
09/19/2007
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