| Marissa R Gonzalez Md Pllc | |
|
220 W Hillside Rd Ste 4a Laredo TX 78041-6903 | |
| (956) 726-6937 | |
| (866) 916-2013 |
| Full Name | Marissa R Gonzalez Md Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 220 W Hillside Rd, Laredo, Texas |
| Authorized Official Name and Position | Marissa R Gonzalez (MEMBER) |
| Authorized Official Contact | 9567266937 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marissa R Gonzalez Md Pllc 220 W Hillside Rd Ste 4a Laredo TX 78041-6903 Ph: (956) 726-6937 | Marissa R Gonzalez Md Pllc 220 W Hillside Rd Ste 4a Laredo TX 78041-6903 Ph: (956) 726-6937 |
| NPI Number | 1609201425 |
|---|---|
| Provider Enumeration Date | 09/11/2013 |
| Last Update Date | 11/15/2021 |
| Medicare PECOS PAC ID | 5294961074 |
|---|---|
| Medicare Enrollment ID | O20131127000350 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609201425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | P4170 (Texas) | Primary |
| Provider Name | Marissa Renee Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104053602 PECOS PAC ID: 1850544420 Enrollment ID: I20130430000446 |
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