Provider Demographics
NPI:1326183153
Name:RONALD GOTANCO P.A.
Entity Type:Organization
Organization Name:RONALD GOTANCO P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:GOTANCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-757-4641
Mailing Address - Street 1:13314 VOELCKER RANCH DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-2250
Mailing Address - Country:US
Mailing Address - Phone:210-757-4641
Mailing Address - Fax:
Practice Address - Street 1:7940 FLOYD CURL DR
Practice Address - Street 2:SUITE 1030
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3905
Practice Address - Country:US
Practice Address - Phone:210-614-3371
Practice Address - Fax:210-614-1055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9707207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPENDINGMedicaid
TXPENDINGMedicare ID - Type Unspecified