Richard John Gong, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G9105 Issued in TX

Practice address

2455 NE Loop 410
Ste 245
San Antonio, TX 78217

Phone

(210) 654-0866

Fax

(210) 654-8723

NPI assigned

Jul 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Richard J Gong Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1346279189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 NE LOOP 410",
            "address_2": "STE 245",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78217",
            "telephone_number": "210-654-0866",
            "fax_number": "210-654-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 NE LOOP 410",
            "address_2": "STE 245",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78217",
            "telephone_number": "210-654-0866",
            "fax_number": "210-654-8723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "RICHARD",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "G9105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TPI",
            "identifier": "032677901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P000D68F8",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICHARD",
            "last_name": "GONG",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "MD PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Veronica Gomez, LVN
• Xochitl Gomez, LMT
• Anish Chandra Gonchigar, MD
• Jennifer Jester Gondos, PT
• Alice Kim Gong, MD
• Edward Gongora
• Camilo Alberto Gonima, M.D.
• Jake Gonta, CTRS
• Michele Gonyer-Russell
• Andrew Michael Gonzaba, MD

• Surgery Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.