Individual
MAYRA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCP
Contact information
Practice address
14603 HUEBNER RD STE 28101, SAN ANTONIO, TX 78230-5497
(210) 614-7074
Mailing address
14603 HUEBNER RD STE 28101, SAN ANTONIO, TX 78230-5497
(210) 614-7074
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
FPF02000046
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FPF02000046
TEXAS MEDICAL BOARD
TX
Enumeration date
10/12/2017
Last updated
09/09/2025
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