Provider Demographics
NPI:1346951266
Name:GONZALEZ, ROBERT DUANE (RPA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DUANE
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 BARCELONA ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3390
Mailing Address - Country:US
Mailing Address - Phone:956-648-5276
Mailing Address - Fax:
Practice Address - Street 1:1406 BARCELONA ST
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3390
Practice Address - Country:US
Practice Address - Phone:956-648-5276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22TX1025243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant