Enrique Gonzalez, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

03991R Issued in LA

Practice address

3217 Mabel St
Shreveport, LA 71103

Phone

(318) 631-9121

Fax

(318) 631-9126

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: enrique.gonzalez@gis.eclinicaldirectplus.com

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.

• Capitol City Family Health Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Baton Rouge, LA
  • NPI 1265548614
  NPD (past)
• Louisiana State University Health Sciences Center

  • Anatomic Pathology & Clinical Pathology Physician
  • Shreveport, LA
  • NPI 1326117003
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1538187752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 MABEL ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034022",
            "telephone_number": "318-631-9121",
            "fax_number": "318-638-6018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 MABEL ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71103",
            "telephone_number": "318-631-9121",
            "fax_number": "318-631-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ENRIQUE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "LA",
            "license": "03991R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1436984",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juan Gomez
• Juan Manuel Gomez
• Gregory Lynn Gonzales
• Elena Gonzalez Caldito, MD
• Eduardo Cesar Gonzalez-Toledo, MD
• Holly Gonzalez, RPSS
• Kimberly Danielle Gooch-Osborne, FNP-C
• Good Deed Transit LLC
• Good Men Health, LLC
• Good Vibes Transportation LLC

• Anatomic Pathology & Clinical Pathology Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.