Provider Demographics
NPI:1164500708
Name:GONZALES, FRANK H III (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:H
Last Name:GONZALES
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-4820
Mailing Address - Country:US
Mailing Address - Phone:830-773-3331
Mailing Address - Fax:830-773-2981
Practice Address - Street 1:290 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-4820
Practice Address - Country:US
Practice Address - Phone:830-773-3331
Practice Address - Fax:830-773-2981
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3145207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128486106Medicaid
TXC16232Medicare UPIN
TXG008273137Medicare ID - Type Unspecified