Individual provider Active NPI

Vincent Gonzales, LSA

  • Surgical Assistant
  • Sugar Land, TX
National Provider Identifier
1083984793
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
SA00666 Issued in TX
Practice address
1 Sugar Creek Center Blvd Ste 618
Sugar Land, TX 77478
Phone
(832) 655-4141
Fax
(713) 457-5188
NPI assigned
Jan 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X SA00666 TX Primary

Addresses

Primary practice location

1 Sugar Creek Center Blvd Ste 618
Sugar Land, TX 77478

Mailing address

1 Sugar Creek Center Blvd Ste 618
Sugar Land, TX 77478-3540
Phone (832) 655-4141

Other identifiers 6

IdentifierTypeStateIssuer
8JY416OtherTXBCBS - UNIVERSAL SURGICAL ASSISTANTS
8PX954OtherTXBCBS - US MSO
8BK141OtherTXBCBS - UNIVERSAL SURGICAL PARTNERS
8KD550OtherTXBCBS - XCITE SURGICAL
8LH924OtherTXBCBS - BLUE STAR SURGICAL ASSISTANTS LLC
SA00666OtherTXTEXAS MEDICAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SA00666TXMDSurgical Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1083984793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SUGAR CREEK CENTER BLVD STE 618",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783540",
            "telephone_number": "832-655-4141",
            "fax_number": "713-457-5188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SUGAR CREEK CENTER BLVD STE 618",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "77478",
            "telephone_number": "832-655-4141",
            "fax_number": "713-457-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "LSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-11",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "SA00666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - UNIVERSAL SURGICAL ASSISTANTS",
            "identifier": "8JY416",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - US MSO",
            "identifier": "8PX954",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - UNIVERSAL SURGICAL PARTNERS",
            "identifier": "8BK141",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - XCITE SURGICAL",
            "identifier": "8KD550",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - BLUE STAR SURGICAL ASSISTANTS LLC",
            "identifier": "8LH924",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "SA00666",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.