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Individual

EDWARD GONGORA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3701 W COMMERCE ST, SAN ANTONIO, TX 78207-3611
(210) 434-0531
(210) 434-0321
Mailing address
3701 W COMMERCE ST, SAN ANTONIO, TX 78207-3611
(210) 434-0531
(210) 434-0321

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10620
TX

Other

Enumeration date
01/11/2019
Last updated
01/11/2019
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