Individual
GONZALO REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 DALLAS ST, ATTN: EMERGENCY ROOM, SAN ANTONIO, TX 78205-1201
(210) 614-0180
(210) 615-7170
Mailing address
PO BOX 12740, WESTMINSTER, CA 92685-2740
(562) 809-3527
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
N1101
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196365401
—
TX
05
—
196365402
—
TX
01
—
8AH279
BCBSTX
TX
Enumeration date
05/07/2007
Last updated
10/29/2009
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