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NPI 1164875902

NPI 1164875902 : JOSE ADOLFO GONZALEZ VILLALBA M.D. : SAN ANTONIO, TX

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General NPI Number Information
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    NPI Number           |    1164875902
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    Entity Type          |    Individual 
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    Provider Name        |    JOSE ADOLFO GONZALEZ VILLALBA M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/18/2016
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    Last Update Date     |    08/01/2025
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Provider Practice Location Address
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    Address Line         |    16620 SAN PEDRO AVE STE 300 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78232-2679
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    Country              |    US
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    Telephone            |    210-871-4701
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    Fax                  |    210-688-4596
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Provider Business Mailing Address
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    Address Line         |    16620 SAN PEDRO AVE STE 300 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78232-2679
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    Country              |    US
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    Telephone            |    210-871-4701
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    Fax                  |    210-688-4596
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    86507
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    License Number State |    SC
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Taxonomy #2
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    Taxonomy Code        |    208M00000X
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    Taxonomy Name        |    Hospitalist Physician
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    License Number       |    D0091283
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    License Number State |    MD
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Taxonomy #3
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    Taxonomy Code        |    208M00000X
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    Taxonomy Name        |    Hospitalist Physician
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    License Number       |    DR.0062854
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    License Number State |    CO
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Taxonomy #4
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    Taxonomy Code        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    U1019
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    License Number State |    TX
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