Active NPI
Mark Gonzales
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Austin, TX
National Provider Identifier
1710379342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- License
- 1001271
- Practice address
- 1101 W 34TH St
Suite 635
Austin, TX 78705-1907 - Phone
- (512) 934-3536
- Fax
- (866) 886-5800
- NPI assigned
- Feb 18, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Physical Medicine & Rehabilitation) Physician | 2081P2900X | 1001271 | TX | Primary |
Addresses
Primary practice location
1101 W 34TH St
Suite 635
Austin, TX 78705-1907
Mailing address
7403 Daugherty St
Austin, TX 78757-2121
Phone (512) 934-3536
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1001271 | TX | MD | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424217600000",
"number": "1710379342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7403 DAUGHERTY ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787572121",
"telephone_number": "512-934-3536",
"fax_number": "866-886-5800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 W 34TH ST",
"address_2": "SUITE 635",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787051907",
"telephone_number": "512-934-3536",
"fax_number": "866-886-5800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-02-18",
"last_updated": "2015-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "2081P2900X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Pain Medicine",
"state": "TX",
"license": "1001271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.