Individual
MICHAEL R GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 MCCULLOUGH AVE, SUITE 300, SAN ANTONIO, TX 78212-4813
(210) 271-3204
(210) 222-2761
Mailing address
1100 MCCULLOUGH AVE, SUITE 300, SAN ANTONIO, TX 78212-4813
(210) 271-3204
(210) 222-2761
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
M4101
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181381803
—
TX
01
—
8CU331
BCBS
TX
01
—
8V3734
BCBS
TX
01
—
P00325412
RAILROAD MEDICARE
TX
01
—
P00948200
RAILROAD
TX
Enumeration date
06/15/2006
Last updated
02/10/2022
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