Organization
BERNICE GONZALEZ, MD, PA
Active
Other names
Vital Life Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERNICE GONZALEZ MD (PRESIDENT)
(210) 595-1019
Entity
Organization
Contact information
Practice address
2520 BROADWAY ST, SUITE 100, SAN ANTONIO, TX 78215-1004
(210) 595-1019
(210) 251-3194
Mailing address
2520 BROADWAY STREET, SUITE 100, SAN ANTONIO, TX 78215
(210) 595-1019
(210) 251-3194
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
J6466
TX
Other
Enumeration date
03/11/2008
Last updated
05/08/2013
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