Individual provider Active NPI

Mark Anthony Gonzalez, MD

  • Family Medicine Physician
  • Victoria, TX
National Provider Identifier
1134866221
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
U6960 Issued in TX
Practice address
2810 N. Ben Wilson St.
Suite 100
Victoria, TX 77901
Phone
(361) 305-6500
Fax
(361) 305-6501
NPI assigned
May 19, 2022
Last updated
Oct 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X U6960 TX Primary

Addresses

Primary practice location

2810 N. Ben Wilson St.
Suite 100
Victoria, TX 77901

Mailing address

2810 N Ben Wilson St Ste 100
Victoria, TX 77901-5641
Phone (361) 305-6500

Other practice location 1

506 E San Antonio St
Victoria, TX 77901-6060
Phone (361) 575-7441

Other practice location 2

9006 N Navarro St Ste B
Victoria, TX 77904-1566
Phone (361) 485-0021

Other identifiers 1

IdentifierTypeStateIssuer
U6960OtherTXTEXAS MEDICAL BOARD LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mark.gonzalez.2@1902.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250723000790 TX Practitioner - Family Practice 3870009111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2810 N Ben Wilson St
Suite 100
Victoria, TX 77901-5641
Phone (361) 305-6500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
U6960TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc Family Medicine CurrentSince Aug 1, 2025 Accepting new patients
Regional Employee Assistance Program Inc Family Medicine CurrentSince Aug 1, 2025 Accepting new patients
Regional Employee Assistance Program Inc Family Medicine Current Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

1602 E Houston St
Ste C
Beeville, TX 78102
Phone (361) 354-2900

2810 N Ben Wilson St
Ste 100
Victoria, TX 77901
Phone (361) 305-6500

501 E Colorado St
Victoria, TX 77901
Phone (361) 571-5283

506 E San Antonio St
Victoria, TX 77901
Phone (361) 575-1445

9006 N Navarro St
Ste B
Victoria, TX 77904
Phone (361) 485-0021

Interoperability endpoints

  • Direct secure messaging: mark.gonzalez.2@1902.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1134866221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 N BEN WILSON ST STE 100",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015641",
            "telephone_number": "361-305-6500",
            "fax_number": "361-305-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 N. BEN WILSON ST.",
            "address_2": "SUITE 100",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "77901",
            "telephone_number": "361-305-6500",
            "fax_number": "361-305-6501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 E San Antonio St",
            "address_purpose": "LOCATION",
            "city": "Victoria",
            "state": "TX",
            "postal_code": "779016060",
            "country_code": "US",
            "telephone_number": "361-575-7441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9006 N Navarro St Ste B",
            "address_purpose": "LOCATION",
            "city": "Victoria",
            "state": "TX",
            "postal_code": "779041566",
            "country_code": "US",
            "telephone_number": "361-485-0021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-19",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "U6960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD LICENSE",
            "identifier": "U6960",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.gonzalez.2@1902.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "2810 N. Ben Wilson St.",
            "address_2": "Suite 100",
            "city": "Victoria",
            "state": "TX",
            "country_code": "US",
            "postal_code": "77901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.