John & Patricia Gonzales

Organization Active NPI Pediatrics Physician · Donna, TX

NPI 1548436686 · NPPES record last updated Oct 14, 2015

Key facts

NPI
1548436686
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
Legal business name
JOHN & PATRICIA GONZALES
Practice address
701 N Main St
Donna, TX 78537-2765
Phone
(956) 464-3649
Fax
(956) 464-3670
NPI assigned
May 7, 2008
Organization subpart
No

Authorized official

Name
Mr. Jerry F. Castilleja, M.D.
Title
Medical Director
Phone
(956) 464-3649

National Provider Directory

Locations

701 N Main St
Donna, TX 78537
Phone (956) 464-3649

701 N Main St
Ste B
Donna, TX 78537
Phone (956) 464-3649

712 Lindberg Ave
McAllen, TX 78501
Phone (956) 682-8800

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208000000X Yes

Addresses

Primary practice location

701 N Main St
Donna, TX 78537-2765

Mailing address

701 N Main St
Suite B
Donna, TX 78537-2765
Phone (956) 464-3649

Other identifiers

IdentifierTypeStateIssuer
190228001MedicaidTX

Other names

  • Divine Children's Clinic Doing business as

Other providers in Donna, TX

All providers in Donna, TX · Pediatrics Physician in Texas

Sources for this page

Verify at the official NPI Registry.