Provider Demographics
NPI:1871599100
Name:GONZALEZ, VICTOR HUGO (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:HUGO
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1309 E RIDGE RD
Mailing Address - Street 2:STE 1
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1518
Mailing Address - Country:US
Mailing Address - Phone:956-631-8875
Mailing Address - Fax:956-682-6280
Practice Address - Street 1:1309 E RIDGE ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1518
Practice Address - Country:US
Practice Address - Phone:956-631-8875
Practice Address - Fax:956-682-6280
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ6115174400000X, 207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No174400000XOther Service ProvidersSpecialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137202111Medicaid
TX081170501Medicaid
TXE96637Medicare UPIN
89490FMedicare PIN
89490FMedicare PIN