Provider Demographics
NPI:1467192724
Name:GONZALEZ, JONATHAN FRANK (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:FRANK
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3551 ROGER BROOKE DR
Mailing Address - Street 2:
Mailing Address - City:JBSA FT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-916-5910
Mailing Address - Fax:210-916-2077
Practice Address - Street 1:SAN ANTONIO MILITARY MEDICAL CENTER, MCHE-ZDM-M
Practice Address - Street 2:INTERNAL MEDICINE RESIDENCY, 3551 ROGER BROOKE DR.
Practice Address - City:JBSA-FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-5910
Practice Address - Fax:210-916-2077
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-01
Last Update Date:2023-10-18
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Provider Licenses
StateLicense IDTaxonomies
VA0101280158208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice