Individual provider Active NPI

David Gonzalez, M.A., CCC/SLP

  • Speech-Language Pathologist
  • Laredo, TX
National Provider Identifier
1265627004
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
101429 Issued in TX
Practice address
2110 Lomas del Sur Ste 114
Laredo, TX 78046-5751
Phone
(956) 712-9111
NPI assigned
Sep 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 101429 TX Primary

Addresses

Primary practice location

2110 Lomas del Sur Ste 114
Laredo, TX 78046-5751

Mailing address

2110 Lomas del Sur Ste 114
Laredo, TX 78046-5751
Phone (956) 712-9111

Other practice location 1

2130 E Griffin Pkwy
Mission, TX 78572-3225
Phone (956) 583-1527

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
101429TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Laredo Autistic and Kids Rehabilitation Center LLC Current Accepting new patients
Laredo Autistic and Kids Rehabilitation Center, LLC Current Accepting new patients
Optimum Kids LTD Past Accepting new patients

Locations

2110 Lomas del Sur
Ste 114
Laredo, TX 78046
Phone (956) 712-9111

2130 E Griffin Pkwy
Mission, TX 78572
Phone (956) 583-1527

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1265627004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 LOMAS DEL SUR STE 114",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780465751",
            "telephone_number": "956-712-9111",
            "fax_number": "956-712-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 LOMAS DEL SUR STE 114",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780465751",
            "telephone_number": "956-712-9111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2130 E Griffin Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mission",
            "state": "TX",
            "postal_code": "785723225",
            "country_code": "US",
            "telephone_number": "956-583-1527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "DAVID",
        "credential": "M.A., CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-13",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "101429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.