MEDICARE: MELISSA GONZALEZ APRN

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	363LF0000X	Family Nurse Practitioner	683177	TX

General Provider Information

NPI Number	:	1992228944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA GONZALEZ APRN

Provider Business Mailing Address
First Line	:	12730 W IH 10 STE 306
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-1004
Country	:	US
Telephone Number	:	210-573-6355
Fax Number	:

Provider Business Practice Location Address
First Line	:	12730 W IH 10 STE 306
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-1004
Country	:	US
Telephone Number	:	210-694-5800
Fax Number	:	210-877-0772

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

Provider Enumeration Date	:	07/21/2017
Last Update Date	:	06/30/2026

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Directions to “ MELISSA GONZALEZ APRN” Practice Location

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