Active NPI
Richard Raul Gonzalez, RD
- Registered Dietitian
- San Antonio, TX
National Provider Identifier
1508530726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT85741
- Practice address
- 7207 Birch Stage
San Antonio, TX 78244-2340 - Phone
- (210) 860-2124
- NPI assigned
- Aug 2, 2021
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nutrition Registered Dietitian | 133VN1004X | DT85741 | TX | |
| Obesity and Weight Management Nutrition Registered Dietitian | 133VN1201X | DT85741 | TX | |
| Sports Dietetics Nutrition Registered Dietitian | 133VN1501X | DT85741 | TX | |
| Registered Dietitian | 133V00000X | DT85741 | TX | Primary |
Addresses
Primary practice location
7207 Birch Stage
San Antonio, TX 78244-2340
Mailing address
7207 Birch Stage
San Antonio, TX 78244-2340
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT85741 | TX | MD | Sports Dietetics Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
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": "1627862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729555200000",
"number": "1508530726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7207 BIRCH STAGE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782442340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7207 BIRCH STAGE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782442340",
"telephone_number": "210-860-2124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "RICHARD",
"middle_name": "RAUL",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-02",
"last_updated": "2024-10-22",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "TX",
"license": "DT85741",
"primary": false
},
{
"code": "133VN1201X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
"state": "TX",
"license": "DT85741",
"primary": false
},
{
"code": "133VN1501X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
"state": "TX",
"license": "DT85741",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT85741",
"primary": true
}
],
"identifiers": [],
"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 Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.