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General NPI Number Information
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NPI Number | 1316296098
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Entity Type | Organization
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Legal Business Name | EDULFO GONZALEZ, M.D., PLLC
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Dates
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Enumeration Date | 09/10/2012
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Last Update Date | 03/10/2023
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Provider Practice Location Address
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Address Line | 8550 HUEBNER RD
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1803
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Country | US
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Telephone | 210-229-9085
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Fax | 210-229-9202
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Provider Business Mailing Address
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Address Line | 4813 FREDERICKSBURG RD STE B
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3664
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Country | US
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Telephone | 210-229-9085
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Fax | 210-229-9202
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Authorized Official
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Title or Position | MEMBER
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Name | EDULFO GONZALEZ-SANCHEZ
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Credential | M.D.
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Telephone | 210-229-9085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G2707
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License Number State | TX
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