Provider Demographics
NPI:1265613483
Name:GONZALES, ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:
Last Name:GONZALES
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 1:8870 US HIGHWAY 87 E
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78263-2242
Mailing Address - Country:US
Mailing Address - Phone:210-648-0152
Mailing Address - Fax:210-649-4170
Practice Address - Street 1:3401 FM 3009
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-2711
Practice Address - Country:US
Practice Address - Phone:210-945-2121
Practice Address - Fax:210-945-2221
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40458183500000X
TXN0798207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No183500000XPharmacy Service ProvidersPharmacist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX38378YT1VMedicare PIN