Individual
JUAN MANUEL GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
117 CIBOLO CREEK LOOP, BASTROP, TX 78602-2246
(361) 541-2756
Mailing address
117 CIBOLO CREEK LOOP, BASTROP, TX 78602-2246
(361) 541-2756
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G3398
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1139180-01
—
TX
Enumeration date
07/19/2005
Last updated
05/23/2024
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