Active NPI
Cleo G Gonzalez, MASSAGE THERAPIST
- Specialist
- San Antonio, TX
National Provider Identifier
1053768804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MT124958
- Practice address
- 85 NE Loop 410
Ste 214
San Antonio, TX 78216-5829 - Phone
- (210) 375-4408
- Fax
- (866) 381-5557
- NPI assigned
- May 23, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MT124958 | TX | Primary |
Addresses
Primary practice location
85 NE Loop 410
Ste 214
San Antonio, TX 78216-5829
Mailing address
85 NE Loop 410
Ste 214
San Antonio, TX 78216-5829
Phone (210) 375-4408
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT124958 | TX | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463961600000",
"number": "1053768804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 NE LOOP 410",
"address_2": "STE 214",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782165829",
"telephone_number": "210-375-4408",
"fax_number": "866-381-5557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 NE LOOP 410",
"address_2": "STE 214",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782165829",
"telephone_number": "210-375-4408",
"fax_number": "866-381-5557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "CLEO",
"middle_name": "G",
"credential": "MASSAGE THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-23",
"last_updated": "2016-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TX",
"license": "MT124958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.