Provider Demographics
NPI:1023267556
Name:RUFINO H. GONZALEZ, M.D., P.A.
Entity type:Organization
Organization Name:RUFINO H. GONZALEZ, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUFINO
Authorized Official - Middle Name:HUGO
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-993-1773
Mailing Address - Street 1:225 CAPE ARON DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-2671
Mailing Address - Country:US
Mailing Address - Phone:361-993-1773
Mailing Address - Fax:361-993-0375
Practice Address - Street 1:2601 HOSPITAL BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1815
Practice Address - Country:US
Practice Address - Phone:361-993-1773
Practice Address - Fax:361-993-0375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3240332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPOOOK7550Medicaid
TX0188230001Medicare NSC
TXB87842Medicare UPIN
TXOOK755Medicare PIN