Provider Demographics
NPI:1730289281
Name:GONZALEZ, RUFINO HUGO (MD)
Entity Type:Individual
Prefix:DR
First Name:RUFINO
Middle Name:HUGO
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:919 HIDDEN RDG
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3813
Mailing Address - Country:US
Mailing Address - Phone:469-282-2711
Mailing Address - Fax:469-282-2609
Practice Address - Street 1:613 ELIZABETH ST
Practice Address - Street 2:SUITE 804
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2220
Practice Address - Country:US
Practice Address - Phone:361-881-3351
Practice Address - Fax:361-861-9022
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3240207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110261806Medicaid
TX110261806Medicaid
TX0188230001Medicare NSC
TX513959YMJMMedicare PIN