Basic Information
Provider Information
NPI: 1699157495
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GONZALEZ RAMOS
FirstName: SAMANTHA
MiddleName: DE LOS ANGELES
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3750 COMMERCIAL AVE
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782213117
CountryCode: US
TelephoneNumber: 2109227000
FaxNumber: 2102717208
Practice Location
Address1: 6315 S ZARZAMORA ST
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782113218
CountryCode: US
TelephoneNumber: 2109220000
FaxNumber: 2109212615
Other Information
ProviderEnumerationDate: 06/29/2015
LastUpdateDate: 07/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XS2983TXY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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