Individual
OMAR GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 E RIDGE RD, MCALLEN, TX 78503-1248
(800) 893-9698
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
F8128
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140092117
—
TX
05
—
140092127
—
TX
01
—
88351X
BCBS
TX
01
—
8X7478
BCBS
TX
Enumeration date
09/12/2006
Last updated
04/23/2008
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