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NPI Code Detail

MEDICARE: MR. REYNALDO C GONZALES RPH

MEDICARE: MR. REYNALDO C GONZALES RPH
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
1183500000XPharmacist17902TX

General Provider Information

NPI Number : 1881935641
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. REYNALDO C GONZALES RPH
Provider Business Mailing Address
First Line : 6000 WEST AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78213-2714
Country : US
Telephone Number : 210-341-3875
Fax Number : 210-344-1887
Provider Business Practice Location Address
First Line : 6000 WEST AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78213-2714
Country : US
Telephone Number : 210-341-3875
Fax Number : 210-344-1887
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2013
Last Update Date : 03/04/2013

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