Individual provider Active NPI

Jessica Marie Gonzalez, MD

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1639179955
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
L1865 Issued in TX
Practice address
19238 Stonehue
San Antonio, TX 78258-3447
Phone
(210) 494-2223
Fax
(210) 494-6516
NPI assigned
Jul 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X L1865 TX Primary

Addresses

Primary practice location

19238 Stonehue
San Antonio, TX 78258-3447

Mailing address

19238 Stonehue
San Antonio, TX 78258-3447
Phone (210) 494-2223

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220915001449 TX Practitioner - Family PracticePractitioner - Pediatric Medicine 6305221151 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L1865TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Pediatrics CurrentSince Nov 1, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Nov 1, 2022 Accepting new patients
Abcd Pediatrics Pediatrics Past Accepting new patients

Locations

21727 Ih 10 W
Ste 205
San Antonio, TX 78257
Phone (210) 698-7663

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: jgonzalez292572@christushealth.direct-ci.net

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639179955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19238 STONEHUE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583447",
            "telephone_number": "210-494-2223",
            "fax_number": "210-494-6516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19238 STONEHUE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583447",
            "telephone_number": "210-494-2223",
            "fax_number": "210-494-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L1865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.