NPI | 1053684761 |
---|---|
Doing Business As | GONZABA MEDICAL GROUP |
Entity Type | Organization |
Authorized Contact | GAIL SOUTHARD Sr Credentialing Specalist 210-921-3867 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX 664714) |
Enumeration Date | 2012-02-13 |
Last Update Date | 2012-02-13 |