MRS. MAGDELENIS GONGORA


Address: 4502 Medical Dr, San Antonio, TX 78229
Phone: 2104509000

MRS. MAGDELENIS GONGORA (NPI# 1871850487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1871850487
Entity Type Individual
Full Name MRS. MAGDELENIS GONGORA
Credential M.D.
Practice Address 4502 Medical Dr
San Antonio
TX 78229
Mailing Address 4502 Medical Dr
San Antonio
TX 78229-4402
Practice Telephone 2104509000
Practice Fax Number 2104504903
Mailing Telephone 2104509000
Mailing Fax Number 2104504903
Enumeration Date 2012-04-19
Last Update Date 2019-05-10
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0203X Pediatrics
Specialization: Pediatric Critical Care Medicine
R8196 TX Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TX CSHCN 395367103 01
TX 395367102 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
1611 Nw 12th Ave, Miami, FL 331361005 3055856042

Office Location

Street Address 4502 MEDICAL DR
City SAN ANTONIO
State TX
Zip Code 78229

Providers in the same location

NPI Name Taxonomy Address Enumeration
1528061017 Sandra E Sanchez-reilly Internal Medicine 4502 Medical Dr, San Antonio, TX 78229 2005-05-27
1356959217 Andrew Sharp Nurse Practitioner 4502 Medical Dr, San Antonio, TX 78229-4402 2020-07-16
1588280895 Juan Manuel Martinez Escallon Student in an Organized Health Care Education/Training Program 4502 Medical Dr, San Antonio, TX 78229-4402 2020-06-23
1982220331 Gabriel Roman Souza Student in an Organized Health Care Education/Training Program 4502 Medical Dr, San Antonio, TX 78229-4402 2020-06-22
1548883689 Sheldon Sugioka Radiologic Technologist 4502 Medical Dr, San Antonio, TX 78229-4402 2020-05-23
1306469895 Hrishikesh Das Student in an Organized Health Care Education/Training Program 4502 Medical Dr, San Antonio, TX 78229-4402 2020-05-19
1427671932 Jacob Daniel Weston Student in an Organized Health Care Education/Training Program 4502 Medical Dr, San Antonio, TX 78229-4402 2020-05-19
1396368882 Yimage Ahmed Surgery 4502 Medical Dr, San Antonio, TX 78229-4402 2020-05-19
1376165001 Jun Hung Student in an Organized Health Care Education/Training Program 4502 Medical Dr, San Antonio, TX 78229-4402 2020-05-15
1407477060 Nicolas Alexander Morton-gonzaba Student in an Organized Health Care Education/Training Program 4502 Medical Dr, San Antonio, TX 78229-4402 2020-05-05
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1245857226 Lyndsey A Sandoval Optometrist 7400 Minton Miner St, San Antonio, TX 78229 2020-06-25
1295355311 Nicolet Finger Student in an Organized Health Care Education/Training Program 7703 Floyd Curl Drive, Mc 7798, San Antonio, TX 78229 2020-04-18
1215557400 Amy Elizabeth Werry Clinical Neuropsychologist 7703 Floyd Circle Drive, San Antonio, TX 78229 2020-04-17
1740822972 Mohammad Safaie Yazdi Student in an Organized Health Care Education/Training Program Ut Health Science Center At San Antonio- Agdc, 8210 Floyd Curl Dr., Msc 8103, San Antonio, TX 78229 2019-10-09
1063053072 Blas Edward Villa Nurse Practitioner 7703 Floyd Curl Drive Mc 7885 Pulmonary Diseases & Crit, Medicine, San Antonio, TX 78229 2019-10-01
1124673942 Integrity Dme Services LLC Durable Medical Equipment & Medical Supplies 6323 Sovereign Dr, Suite # 170 Ab, San Antonio, TX 78229 2019-08-08
1730734120 Marisa Erin Leyden Speech-Language Pathologist Joe R. & Teresa Lozano Long Campus, 7703 Floyd Curl Dr., San Antonio, TX 78229 2019-08-03
1285295741 Alireza Ghezavati Student in an Organized Health Care Education/Training Program 7703 Floyd Curl Drive Mc 7750, Department of Pathology and Laboratory Medicine, San Antonio, TX 78229 2019-06-25
1407410285 Denae Cheyenne Rushing Student in an Organized Health Care Education/Training Program 8201 Floyd Curl Drive, San Antonio, TX 78229 2019-04-26
1265993570 Shehzad Amlani Student in an Organized Health Care Education/Training Program Address: 7703 Floyd Curl Dr, San Antonio, TX 78229 2019-03-28
Find all providers in zip 78229

Taxonomy Information

Taxonomy Code 2080P0203X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Critical Care Medicine

Taxonomy Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics)

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1619934098 Candace Campos Kenton Pediatrics 302 W Lynwood Ave, San Antonio, TX 78212-2592 2006-04-28
1831156595 Samuel L. Zuckerman Pediatrics 315 N San Saba Ste 1135, San Antonio, TX 78207-3255 2006-04-27
1386601888 Najmul H. Salman Pediatrics 11019 Culebra Rd Ste 155, San Antonio, TX 78253-4519 2006-04-27
1104219781 Pediatric Inpatient Critical Care Services Pa Pediatrics 520 Madison Oak Dr, San Antonio, TX 78258-3913 2015-03-06
1487061321 Niveditha Balakumar Pediatrics 333 N Santa Rosa St, San Antonio, TX 78207-3108 2014-07-11
1720408578 Kirstin Henley Pediatrics 333 N Santa Rosa St, San Antonio, TX 78207-3108 2014-04-21
1255604104 Utpal S Bhalala Pediatrics 315 N San Saba, Suite 1135, San Antonio, TX 78207-3154 2012-02-22
1528395985 Mohammed Salameh Pediatrics 333 N Santa Rosa St, San Antonio, TX 78207-3108 2009-11-05
1598921223 Childrens Critical Care Specialists Pllc Pediatrics 7700 Floyd Curl Dr, San Antonio, TX 78229-3902 2008-08-01
1588821797 Thomas Jacob Lee Jr. Pediatrics Brooke Army Medical Center, 3551 Roger Brooke Dr, San Antonio, TX 78234 2008-05-16
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Competitor

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City SAN ANTONIO
Zip Code 78229

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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