Individual
RICARDO GARZA-GONGORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
(254) 724-7603
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M9304
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942462544
—
VA
01
—
M9304
TX MEDICAL BOARD
TX
Enumeration date
06/26/2008
Last updated
12/17/2021
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