Provider Demographics
NPI:1033157060
Name:GONZALEZ-ANGULO, CARLOS EDUARDO
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:EDUARDO
Last Name:GONZALEZ-ANGULO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:2150 N EXPRESSWAY
Practice Address - Street 2:SUITE 83
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-1561
Practice Address - Country:US
Practice Address - Phone:956-548-0810
Practice Address - Fax:956-548-2198
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK75442085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R1447OtherBLUE CROSS OF TEXAS
TX8R1447OtherBLUE CROSS OF TEXAS
TXG61954Medicare UPIN
TX85520NMedicare PIN