Healthcare Provider Details

I. General information

NPI: 1215926514
Provider Name (Legal Business Name): VERONICA MAYELA GONZALEZ-BROWN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 MADISON OAK DR STE 210
SAN ANTONIO TX
78258-4192
US

IV. Provider business mailing address

PO BOX 2271
SAN ANTONIO TX
78298-2271
US

V. Phone/Fax

Practice location:
  • Phone: 210-481-3000
  • Fax:
Mailing address:
  • Phone: 210-481-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberT2611
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: