Individual provider Active NPI

Lizette Gonzales, M.D.

  • Family Medicine Physician
  • Austin, TX
National Provider Identifier
1205121597
Registry record updated Dec 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P7448 Issued in TX
Practice address
9900 S Ih 35
Austin, TX 78748-3885
Phone
(512) 291-5577
Fax
(512) 291-5576
NPI assigned
Jun 14, 2011
Last updated
Dec 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2017

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 P7448 TX Primary

Addresses

Primary practice location

9900 S Ih 35
Austin, TX 78748-3885

Mailing address

809 S Lamar Blvd Apt 417
Austin, TX 78704-1573
Phone (512) 740-8254

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
I20140826001219 TX Practitioner - General Practice 4789802232 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of Texas Medical Branch at Galveston, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMC Provider Group PLLCGroup PAC ID 6305149121, 213 clinicians

Practice addresses (Care Compare)

23611W Interstate 10
San Antonio, TX 78257-1694
Phone (210) 698-6617

9900S Interstate 35
Austin, TX 78748-3885
Phone (512) 291-5577

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Provider Group PLLC CurrentSince Jan 1, 2016 Accepting new patients
TMC Provider Group PLLC Current Accepting new patients
TMC Provider Group PLLC Family Medicine CurrentSince Jan 1, 2016 Accepting new patients
TMC Provider Group PLLC Family Medicine Past Accepting new patients
TMC Provider Group PLLC Family Medicine Past Accepting new patients

Locations

9900 S Interstate 35
Austin, TX 78748
Phone (512) 291-5577

13722 Embassy Row
San Antonio, TX 78216
Phone (210) 349-5577

23611 W Interstate 10
San Antonio, TX 78257
Phone (210) 698-6617

Organizations & group practices 6

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": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514332800000",
    "number": "1205121597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 S LAMAR BLVD APT 417",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787041573",
            "telephone_number": "512-740-8254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 S IH 35",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787483885",
            "telephone_number": "512-291-5577",
            "fax_number": "512-291-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "LIZETTE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2017-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P7448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.