Individual provider Active NPI

Ernesto Gonzalez, PHARMD

  • Pharmacist
  • Dallas, TX
National Provider Identifier
1164944187
Registry record updated Jul 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
56981 Issued in TX
Practice address
2305 N Central Expy
Dallas, TX 75204-3800
Phone
(214) 953-0165
NPI assigned
Jul 11, 2017
Last updated
Jul 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 56981 TX Primary

Addresses

Primary practice location

2305 N Central Expy
Dallas, TX 75204-3800

Mailing address

4420 Dickason Ave Apt 1233
Dallas, TX 75219-6643

Other identifiers 1

IdentifierTypeStateIssuer
56981OtherTXTEXAS STATE BOARD OF PHARMACY

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
56981TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores Texas, LLC Past Accepting new patients
Wal-Mart Stores Texas LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499731200000",
    "number": "1164944187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 DICKASON AVE APT 1233",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752196643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 N CENTRAL EXPY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752043800",
            "telephone_number": "214-953-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ERNESTO",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-11",
        "last_updated": "2017-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "56981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF PHARMACY",
            "identifier": "56981",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2017; 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.