Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 08421 | IA |
N | 213EG0000X | General Practice | 08421 | IA |
Y | 1223P0106X | Oral and Maxillofacial Pathology | 08421 | IA |
NPI | 1487767737 |
---|---|
Provider Name | Dr. Karen Enid Gonzaleztorres |
First Address | San Antonio, TX 78259-4403 |
Second Address | Jbsa Ft Sam Houston, TX 78234-4504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 23/10/2020 |