Individual provider Active NPI

Jose Luis Gonzalez

  • Optician
  • San Antonio, TX
National Provider Identifier
1548784978
Registry record updated Jul 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
220325 Issued in TX
Practice address
9400 Perrin Beitel Rd Ste 102
San Antonio, TX 78217-3511
Phone
(210) 251-4740
NPI assigned
Jul 27, 2017
Last updated
Jul 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 220325 TX Primary

Addresses

Primary practice location

9400 Perrin Beitel Rd Ste 102
San Antonio, TX 78217-3511

Mailing address

5803 Liberty Bell St
San Antonio, TX 78233-5254
Phone (432) 803-8309

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

LicenseStateTypeSpecialty
220325TXMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501113600000",
    "number": "1548784978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5803 LIBERTY BELL ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782335254",
            "telephone_number": "432-803-8309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 PERRIN BEITEL RD STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782173511",
            "telephone_number": "210-251-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-27",
        "last_updated": "2017-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "TX",
            "license": "220325",
            "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 Jul 27, 2017; 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.