NPIMap

Organization Active NPI

Diana Gonzalez, OD, & Associates, PA

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1386610939
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5906TG Issued in TX
Legal business name
DIANA GONZALEZ, OD, & ASSOCIATES, PA
Practice address
21126 Market RDG
San Antonio, TX 78258-4984
Phone
(210) 305-5555
Fax
(210) 402-5435
NPI assigned
Feb 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Authorized official

Name
Dr. Diana Gonzalez, O.D.NPI 1558398420
Title
President
Phone
(210) 305-5555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 5906TG TX Primary

Addresses

Primary practice location

21126 Market RDG
San Antonio, TX 78258-4984

Mailing address

21126 Market RDG
San Antonio, TX 78258-4984
Phone (210) 305-5555

Other identifiers 11

IdentifierTypeStateIssuer
81168QOtherTXBLUE CROSS BLUE SHIELD
GO1319495OtherTXCLARITY
44973OtherTXDAVIS VISION
91FEOtherTXBLUE CROSS BLUE SHIELD
18978OtherTXCTC/LIFERE/
24855OtherTXSPECTERA
451909OtherTXNATIONAL VISION ADMIN
55748OtherTXSAFEGUARD/SAFEHEALTH
13622OtherTXHUMANA
33093OtherTXAVESIS
TX5906OtherTXEYEMED VISION CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041221000761 TX Part B Supplier - Clinic/Group Practice 7012975154 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

2339 E Evans Rd
Ste 104
San Antonio, TX 78259
Phone (210) 305-5555

21126 Market Rdg
San Antonio, TX 78258
Phone (210) 305-5555

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1386610939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21126 MARKET RDG",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584984",
            "telephone_number": "210-305-5555",
            "fax_number": "210-402-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21126 MARKET RDG",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584984",
            "telephone_number": "210-305-5555",
            "fax_number": "210-402-5435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANA GONZALEZ, OD, & ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-24",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-305-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5906TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "81168Q",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLARITY",
            "identifier": "GO1319495",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "44973",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "91FE",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CTC/LIFERE/",
            "identifier": "18978",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "24855",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL VISION ADMIN",
            "identifier": "451909",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAFEGUARD/SAFEHEALTH",
            "identifier": "55748",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "13622",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "33093",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED VISION CARE",
            "identifier": "TX5906",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.