Individual provider Active NPI

Lizmarie Gonzalez-Vega, M.D.

  • Child & Adolescent Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1770764904
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
N6876 Issued in TX
Practice address
8535 Tom Slick
San Antonio, TX 78229-3367
Phone
(210) 582-6440
Fax
(210) 692-9021
NPI assigned
Nov 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X N6876 TX Primary
Psychiatry Physician 2084P0800X N6876 TX

Addresses

Primary practice location

8535 Tom Slick
San Antonio, TX 78229-3367

Mailing address

8535 Tom Slick
San Antonio, TX 78229-3367
Phone (210) 582-6440

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
I20120619000619 TX Practitioner - Psychiatry 2062676216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Ponce School of Medicine, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Southwest Psychiatric PhysiciansGroup PAC ID 7416852066, 5 clinicians

Practice addresses (Care Compare)

8535 Tom Slick
San Antonio, TX 78229-3367
Phone (210) 582-6450

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Child Guidance Center Past Accepting new patients

Organizations & group practices 2

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": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1770764904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8535 TOM SLICK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293367",
            "telephone_number": "210-582-6440",
            "fax_number": "210-692-9021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8535 TOM SLICK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293367",
            "telephone_number": "210-582-6440",
            "fax_number": "210-692-9021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ-VEGA",
        "first_name": "LIZMARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "N6876",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "N6876",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.