| Omar Gonzalez, M.d., P.a. | |
|
1715 Saul Kleinfield Bldg A El Paso TX 79936 | |
| (915) 222-8275 | |
| (915) 544-5696 |
| Full Name | Omar Gonzalez, M.d., P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1715 Saul Kleinfield Bldg A, El Paso, Texas |
| Authorized Official Name and Position | Omar Gonzalez (PRESIDENT) |
| Authorized Official Contact | 9152531757 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Omar Gonzalez, M.d., P.a. Po Box 71449 El Paso TX 79917-1449 Ph: (915) 222-8275 | Omar Gonzalez, M.d., P.a. 1715 Saul Kleinfield Bldg A El Paso TX 79936 Ph: (915) 222-8275 |
| NPI Number | 1437196276 |
|---|---|
| Provider Enumeration Date | 06/01/2006 |
| Last Update Date | 02/20/2012 |
| Medicare PECOS PAC ID | 5496738379 |
|---|---|
| Medicare Enrollment ID | O20040610001693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437196276 | NPI | - | NPPES |
| 150280902 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | K4440 (Texas) | Primary |
| Provider Name | Omar Gonzalez-camarena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780682260 PECOS PAC ID: 1759364631 Enrollment ID: I20111222000359 |
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