Provider Demographics
NPI:1851619589
Name:GONZALEZ, HELENA CHENG (MD)
Entity Type:Individual
Prefix:DR
First Name:HELENA
Middle Name:CHENG
Last Name:GONZALEZ
Suffix:
Gender:F
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:PO BOX 26726
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78755-0726
Mailing Address - Country:US
Mailing Address - Phone:512-407-8686
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:10401 ANDERSON MILL RD
Practice Address - Street 2:SUITE 110B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2581
Practice Address - Country:US
Practice Address - Phone:512-250-5571
Practice Address - Fax:512-331-0960
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10036635208000000X
TXP6624208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX323467602Medicaid
TX323467601Medicaid
TX299824YKXYMedicare PIN
TX299825YKXVMedicare PIN