Active NPI
David Gonzalez, M.A., CCC/SLP
- Speech-Language Pathologist
- Laredo, TX
National Provider Identifier
1265627004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 101429
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 101429 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Rehabilitation Clinic/Center
- Laredo, TX
- NPI 1023336773
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Laredo, TX
- NPI 1053641910
-
- Rehabilitation Clinic/Center
- Mission, TX
- NPI 1619940012
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.