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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
R8196 | TX | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | CSHCN | 395367103 | 01 |
TX | 395367102 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
1611 Nw 12th Ave, Miami, FL 331361005 | 3055856042 |
Street Address |
4502 MEDICAL DR |
City | SAN ANTONIO |
State | TX |
Zip Code | 78229 |
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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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 Code | 2080P0203X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
Specialization | Pediatric Critical Care Medicine |
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) |
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 |
Find all providers in SAN ANTONIO |
City | SAN ANTONIO |
Zip Code | 78229 |
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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.