Provider Demographics
NPI:1205966413
Name:GONZALEZ, MARIA GUADALUPE (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:GUADALUPE
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 1:226 FLAMINGO ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4610
Mailing Address - Country:US
Mailing Address - Phone:281-835-6230
Mailing Address - Fax:
Practice Address - Street 1:7500 BEECHNUT ST STE 352
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-4337
Practice Address - Country:US
Practice Address - Phone:713-666-3200
Practice Address - Fax:713-666-3201
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1866207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167069701Medicaid
TX352226687OtherFAMILY PRACTICE