Provider Demographics
NPI:1245292937
Name:GONZALEZ, DAWN E (DO)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:E
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 W WHEATLAND RD
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4518
Mailing Address - Country:US
Mailing Address - Phone:972-296-2985
Mailing Address - Fax:972-296-9915
Practice Address - Street 1:630 W WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4518
Practice Address - Country:US
Practice Address - Phone:972-296-2985
Practice Address - Fax:972-296-9915
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2022207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103591707Medicaid
TX8BW458OtherBCBS
TX8BW458OtherBCBS
TX103591707Medicaid