NPIMap

Organization Active NPI

Gonzales Healthcare Systems

Doing business as Memorial Hospital

  • General Acute Care Hospital
  • Gonzales, TX
National Provider Identifier
1508859612
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
000103 Issued in TX
Legal business name
GONZALES HEALTHCARE SYSTEMS
Doing business as
Memorial Hospital
Practice address
1110 N Sarah Dewitt Dr
Gonzales, TX 78629-3311
Phone
(830) 672-7581
Fax
(830) 672-2401
NPI assigned
Aug 24, 2005
Last updated
Jul 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Mr. Brandon Anzaldua
Title
Ceo/Administrator
Phone
(830) 672-7581

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 000103 TX Primary

Addresses

Primary practice location

1110 N Sarah Dewitt Dr
Gonzales, TX 78629-3311

Mailing address

PO Box 587
Gonzales, TX 78629-0587
Phone (830) 672-7581

Other practice location 1

207 W 7th St
Shiner, TX 77984-5873
Phone (361) 239-5015

Other practice location 2

1300 Captain Albert Martin Trail
Gonzales, TX 78629-7862
Phone (830) 672-7581

Other identifiers 1

IdentifierTypeStateIssuer
007150801MedicaidTX

Other names 1

  • Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040316001074 TX Part B Supplier - Clinic/Group Practice 8527963776 Receives reassigned benefits from 56 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Shiner, TX; Gonzales, TX

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Gonzales Healthcare Systems13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1110 E Sarah Dewitt Dr
Gonzales, TX 78629

1605 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-4601

312 Saint Francis St
Gonzales, TX 78629
Phone (830) 672-4627

124 E Wolters 2nd St
Ste B
Shiner, TX 77984
Phone (361) 594-2520

Practitioners & affiliated clinicians

Practitioners 60

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1508859612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 587",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786290587",
            "telephone_number": "830-672-7581",
            "fax_number": "830-672-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 N SARAH DEWITT DR",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786293311",
            "telephone_number": "830-672-7581",
            "fax_number": "830-672-2401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 W 7th St",
            "address_purpose": "LOCATION",
            "city": "Shiner",
            "state": "TX",
            "postal_code": "779845873",
            "country_code": "US",
            "telephone_number": "361-239-5015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 Captain Albert Martin Trail",
            "address_purpose": "LOCATION",
            "city": "Gonzales",
            "state": "TX",
            "postal_code": "786297862",
            "country_code": "US",
            "telephone_number": "830-672-7581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GONZALES HEALTHCARE SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "ANZALDUA",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "830-672-7581",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": "000103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007150801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gonzales, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.