Individual provider Active NPI

Vanessa Gonzalez, AGACNP

  • Nurse Practitioner
  • Live Oak, TX
National Provider Identifier
1164076071
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1027875 Issued in TX
Practice address
12500 Judson Rd
Live Oak, TX 78233-4146
Phone
(210) 967-0096
NPI assigned
Jul 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1027875 TX
Nurse Practitioner 363L00000X 1027875 TX Primary

Addresses

Primary practice location

12500 Judson Rd
Live Oak, TX 78233-4146

Mailing address

12500 Judson Rd
Live Oak, TX 78233-4146
Phone (210) 967-0096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260515003949 TX Practitioner - Nurse Practitioner 8022587278

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiology Clinic of San Antonio, PLLC 125 clinicians

Practice addresses (Care Compare)

12500 Judson Rd
Suite 300
Live Oak, TX 78233-4146
Phone (210) 967-0096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1027875TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Clinic of San Antonio, PLLC CurrentSince Jul 1, 2026 Accepting new patients
First Choice Childrens Homecare LP PastSince Aug 6, 2019 Accepting new patients
San Antonio Cardiology Clinic PA PastSince Jul 1, 2026 Accepting new patients

Locations

12500 Judson Rd
Ste 300
Live Oak, TX 78233
Phone (210) 473-0246

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1164076071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12500 JUDSON RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782334146",
            "telephone_number": "210-967-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 JUDSON RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782334146",
            "telephone_number": "210-967-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "VANESSA",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1027875",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1027875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

Verify at the official NPI Registry.