| Penelope Gonzalez Md Pa | |
|
6624 Fannin St Ste 2250 Houston TX 77030-2308 | |
| (713) 790-0003 | |
| (713) 797-9821 |
| Full Name | Penelope Gonzalez Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 6624 Fannin St Ste 2250, Houston, Texas |
| Authorized Official Name and Position | Penelope Gonzalez (SOLE PROPRIETOR) |
| Authorized Official Contact | 7132568198 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Penelope Gonzalez Md Pa Po Box 25124 Houston TX 77265-5124 Ph: (713) 256-8198 | Penelope Gonzalez Md Pa 6624 Fannin St Ste 2250 Houston TX 77030-2308 Ph: (713) 790-0003 |
| NPI Number | 1912121831 |
|---|---|
| Provider Enumeration Date | 04/12/2007 |
| Last Update Date | 11/17/2009 |
| Medicare PECOS PAC ID | 1052410560 |
|---|---|
| Medicare Enrollment ID | O20070625000480 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912121831 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | L6402 (Texas) | Primary |
| Provider Name | Penelope Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104858711 PECOS PAC ID: 3476534496 Enrollment ID: I20070222000534 |
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