MEDICARE: EDULFO GONZALEZ-SANCHEZ 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
1	2084P0800X	Psychiatry Physician	G2707	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8DK928	OTHER	TX	BCBSTX
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942591151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDULFO GONZALEZ-SANCHEZ M.D.

Provider Business Mailing Address
First Line	:	4813 FREDERICKSBURG RD STE B
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3664
Country	:	US
Telephone Number	:	210-229-9085
Fax Number	:	210-229-9202

Provider Business Practice Location Address
First Line	:	4813 FREDERICKSBURG RD STE B
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3664
Country	:	US
Telephone Number	:	210-229-9085
Fax Number	:	210-229-9202

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2011
Last Update Date	:	03/10/2023

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