Provider Demographics
NPI:1972784197
Name:GONZALEZ, ENRIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:ENRIQUE
Middle Name:
Last Name:GONZALEZ
Suffix:
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 1:2851 N MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-1109
Mailing Address - Country:US
Mailing Address - Phone:254-939-1844
Mailing Address - Fax:254-618-1619
Practice Address - Street 1:2851 N MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-1109
Practice Address - Country:US
Practice Address - Phone:254-939-1844
Practice Address - Fax:254-618-1619
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2860207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine