Individual provider Active NPI

Angel Mario Morales Gonzalez, M.D.

  • Surgery Physician
  • El Paso, TX
National Provider Identifier
1356540215
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
56176 Issued in TN
Practice address
10400 Vista del Sol Dr
Suite 101
El Paso, TX 79925-7945
Phone
(915) 422-7346
Fax
(915) 503-2292
NPI assigned
Jul 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 56176 TN Primary

Addresses

Primary practice location

10400 Vista del Sol Dr
Suite 101
El Paso, TX 79925-7945

Mailing address

1941 W T C Jester Blvd # 102
Houston, TX 77008-1200
Phone (713) 777-5476

Other identifiers 1

IdentifierTypeStateIssuer
N0289OtherTX MEDICAL LIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090812000321 TX Practitioner - Colorectal Surgery (Proctology) 2264586197 Reassigns benefits to 3 organizations
I20220228000416 FL Practitioner - General Surgery 2264586197

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince May 1, 2021 Accepting new patients
Vpa of Texas PLLC CurrentSince May 1, 2021 Accepting new patients
El Paso del Norte Surgical Group, PA Surgery CurrentSince Jan 3, 2014 Accepting new patients

Locations

1655 Mosswood St
El Paso, TX 79935
Phone (915) 591-7700

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

Organizations & group practices 4

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": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1356540215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 W T C JESTER BLVD # 102",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081200",
            "telephone_number": "713-777-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 VISTA DEL SOL DR",
            "address_2": "SUITE 101",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799257945",
            "telephone_number": "915-422-7346",
            "fax_number": "915-503-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES GONZALEZ",
        "first_name": "ANGEL",
        "middle_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "56176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX MEDICAL LIC",
            "identifier": "N0289",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.