Provider Demographics
NPI:1427077817
Name:MONSALVEZ, JOSE GABRIEL (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:GABRIEL
Last Name:MONSALVEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 SOUTHWEST FWY STE 1100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7358
Mailing Address - Country:US
Mailing Address - Phone:713-961-0086
Mailing Address - Fax:713-961-0043
Practice Address - Street 1:4126 SOUTHWEST FWY STE 1100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7358
Practice Address - Country:US
Practice Address - Phone:713-961-0086
Practice Address - Fax:713-961-0043
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE58602086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031893301Medicaid
TX00AK64OtherBCBSTX
TX10015944OtherAMERIGROUP
TX031893301Medicaid
TXB24968Medicare UPIN