Active NPI
Gonzalo Perez del Puerto, MD
- Family Medicine Physician
- Plano, TX
National Provider Identifier
1386844827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301111028
- Practice address
- 7613 Trevino Dr
Plano, TX 75025-6132 - Phone
- (214) 704-2794
- NPI assigned
- Jul 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301111028 | MI | Primary |
Addresses
Primary practice location
7613 Trevino Dr
Plano, TX 75025-6132
Mailing address
7613 Trevino Dr
Plano, TX 75025-6132
Phone (214) 704-2794
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301111028 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479772800000",
"number": "1386844827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7613 TREVINO DR",
"city": "PLANO",
"state": "TX",
"postal_code": "750256132",
"telephone_number": "214-704-2794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7613 TREVINO DR",
"city": "PLANO",
"state": "TX",
"postal_code": "750256132",
"telephone_number": "214-704-2794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ DEL PUERTO",
"first_name": "GONZALO",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-23",
"last_updated": "2016-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301111028",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.