NPIMap

Organization Active NPI

Peter C. W. Gonzales, M.D., P.a.

  • Neurology Physician
  • Irving, TX
National Provider Identifier
1558313643
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
PETER C. W. GONZALES, M.D., P.A.
Practice address
3204 N Macarthur Blvd
Suite B
Irving, TX 75062-4453
Phone
(972) 870-5500
Fax
(972) 870-5504
NPI assigned
May 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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

Authorized official

Name
Dr. Peter Chan Wong Gonzales, M.D.
Title
President
Phone
(972) 870-5500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0402X
Clinical Neurophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0600X

Addresses

Primary practice location

3204 N Macarthur Blvd
Suite B
Irving, TX 75062-4453

Mailing address

3204 N Macarthur Blvd
Suite B
Irving, TX 75062-4453
Phone (972) 870-5500

Other identifiers 1

IdentifierTypeStateIssuer
0053BFOtherTXBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

3204 N MacArthur Blvd
Ste B
Irving, TX 75062
Phone (972) 870-5500

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184284800000",
    "number": "1558313643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 N MACARTHUR BLVD",
            "address_2": "SUITE B",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750624453",
            "telephone_number": "972-870-5500",
            "fax_number": "972-870-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 N MACARTHUR BLVD",
            "address_2": "SUITE B",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750624453",
            "telephone_number": "972-870-5500",
            "fax_number": "972-870-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER C. W. GONZALES, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2007-07-13",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "CHAN  WONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-870-5500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0053BF",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.