Individual provider Active NPI

Dagoberto I Gonzalez Jr., MD

  • Obstetrics & Gynecology Physician
  • Laredo, TX
National Provider Identifier
1326029869
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
K3902 Issued in TX
Practice address
7109 Bartlett Ave Sute 101
Laredo, TX 78041
Phone
(956) 717-5775
Fax
(956) 717-5875
NPI assigned
Nov 10, 2005
Last updated
Jun 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X K3902 TX Primary

Addresses

Primary practice location

7109 Bartlett Ave Sute 101
Laredo, TX 78041

Mailing address

7109 Bartlett Ave Sute 101
Laredo, TX 78041
Phone (956) 717-5775

Other identifiers 2

IdentifierTypeStateIssuer
1654683-01MedicaidTX
8M7440OtherTXBLUE CROSS BLUE SHIELD

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
I20040701000848 TX Practitioner - Obstetrics/Gynecology 8729065537 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Texas a & M University System, HSC, College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Obstetrics and Gynecology Associates of Laredo, P.a.Group PAC ID 6901883834, 3 clinicians

Practice addresses (Care Compare)

7109 N Bartlett Ave
Suite 101
Laredo, TX 78041-6473
Phone (956) 717-5775

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Obstetrics and Gynecology Associates of Laredo, P.a. Obstetrics & Gynecology CurrentSince Jul 1, 2004 Accepting new patients
Gateway Community Health Center Inc CurrentSince Dec 17, 2019 Accepting new patients
Gateway Community Health Center, Inc Current Accepting new patients
Gateway Community Health Center, Inc CurrentSince Dec 17, 2019 Accepting new patients
Laredo Texas Hospital Company LP Past Accepting new patients

Locations

10700 McPherson Rd
Laredo, TX 78045
Phone (956) 523-2068

1515 Pappas St
Laredo, TX 78041
Phone (956) 523-3642

7109 N Bartlett Ave
Ste 101
Laredo, TX 78041
Phone (956) 717-5775

Interoperability endpoints

  • Direct secure messaging: dagoberto.gonzalez@tx013.digichart.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1326029869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7109 BARTLETT AVE SUTE 101",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "78041",
            "telephone_number": "956-717-5775",
            "fax_number": "956-717-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7109 BARTLETT AVE SUTE 101",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "78041",
            "telephone_number": "956-717-5775",
            "fax_number": "956-717-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "DAGOBERTO",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "K3902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1654683-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8M7440",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.