Provider Demographics
NPI:1932186251
Name:GONZALEZ, LUIS E (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:E
Last Name:GONZALEZ
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 1:7520 FM 3180 RD STE 500
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77523-5007
Mailing Address - Country:US
Mailing Address - Phone:832-808-7095
Mailing Address - Fax:832-327-7633
Practice Address - Street 1:7520 FM 3180 RD STE 500
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77523-5007
Practice Address - Country:US
Practice Address - Phone:832-808-7095
Practice Address - Fax:832-327-7633
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3399207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00GG64Medicare PIN
TX00GG64Medicare ID - Type Unspecified