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NPI Code Detail

MEDICARE: DR. WILLIAM THOMAS GONZABA M.D.

MEDICARE:  DR. WILLIAM THOMAS GONZABA  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianK9789TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1110212729OTHERTXRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548231905
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM THOMAS GONZABA M.D.
Provider Business Mailing Address
First Line : 720 PLEASANTON RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78214-1306
Country : US
Telephone Number : 210-921-3800
Fax Number : 210-921-6620
Provider Business Practice Location Address
First Line : 720 PLEASANTON RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78214-1306
Country : US
Telephone Number : 210-921-3800
Fax Number : 210-921-6620
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 01/12/2015

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Directions to “ DR. WILLIAM THOMAS GONZABA M.D.” Practice Location

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