Individual provider Active NPI

Frank H Gonzales III, MD

  • Family Medicine Physician
  • Eagle Pass, TX
National Provider Identifier
1164500708
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F3145 Issued in TX
Practice address
290 Jefferson St
Eagle Pass, TX 78852-4820
Phone
(830) 773-3331
Fax
(830) 773-2981
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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 F3145 TX Primary

Addresses

Primary practice location

290 Jefferson St
Eagle Pass, TX 78852-4820

Mailing address

290 Jefferson St
Eagle Pass, TX 78852-4820
Phone (830) 773-3331

Other identifiers 1

IdentifierTypeStateIssuer
128486106MedicaidTX

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1164500708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 JEFFERSON ST",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788524820",
            "telephone_number": "830-773-3331",
            "fax_number": "830-773-2981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 JEFFERSON ST",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788524820",
            "telephone_number": "830-773-3331",
            "fax_number": "830-773-2981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "FRANK",
        "middle_name": "H",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F3145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128486106",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Pass, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; 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.