Provider Demographics
NPI:1649432436
Name:GONZALEZ, REFUGIO III (DDS)
Entity type:Individual
Prefix:DR
First Name:REFUGIO
Middle Name:
Last Name:GONZALEZ
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13725 NORTHWEST BLVD STE 270
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-5123
Mailing Address - Country:US
Mailing Address - Phone:361-992-9500
Mailing Address - Fax:
Practice Address - Street 1:8131 DORADO DR
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79765-8533
Practice Address - Country:US
Practice Address - Phone:432-272-1190
Practice Address - Fax:800-532-0728
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC99571223P0221X
390200000X
TX239191223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program