Individual provider Active NPI

Martha Alejandra Gonzalez, DO

  • Family Medicine Physician
  • Irving, TX
National Provider Identifier
1487217618
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T3288 Issued in TX
Practice address
5601 Executive Dr Ste 200
Irving, TX 75038-2508
Phone
(352) 565-7290
Fax
(352) 565-7290
NPI assigned
Apr 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X T3288 TX Primary

Addresses

Primary practice location

5601 Executive Dr Ste 200
Irving, TX 75038-2508

Mailing address

5601 Executive Dr Ste 200
Irving, TX 75038-2508
Phone (352) 565-7290

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
I20220728000656 TX Practitioner - Family Practice 1355670902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valora Medical Center LLCGroup PAC ID 4880095983, 13 clinicians

Practice addresses (Care Compare)

825 Desco LN
Grand Prairie, TX 75051-1685
Phone (844) 825-6724

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T3288TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valora Medical Center LLC CurrentSince Aug 15, 2022 Accepting new patients

Locations

1004 S Carrier Pkwy
Grand Prairie, TX 75051
Phone (214) 677-1300

5601 Executive Dr
Ste 200
Irving, TX 75038
Phone (352) 565-7290

Organizations & group practices 1

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": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1487217618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 EXECUTIVE DR STE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382508",
            "telephone_number": "352-565-7290",
            "fax_number": "352-565-7290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 EXECUTIVE DR STE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382508",
            "telephone_number": "352-565-7290",
            "fax_number": "352-565-7290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MARTHA",
        "middle_name": "ALEJANDRA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-14",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T3288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.