Provider Demographics
NPI:1285733782
Name:GUNSBERG, ANNETTE (MD)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:GUNSBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 OAK CENTRE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3936
Mailing Address - Country:US
Mailing Address - Phone:210-403-2229
Mailing Address - Fax:210-403-2524
Practice Address - Street 1:540 OAK CENTRE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3936
Practice Address - Country:US
Practice Address - Phone:210-403-2229
Practice Address - Fax:210-403-2524
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3317208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF85430Medicare UPIN