Provider Demographics
NPI:1043479181
Name:MCDERMOTT-GONZALEZ, LINDA MARIE (PNP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARIE
Last Name:MCDERMOTT-GONZALEZ
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 N JEFFERSON AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-2386
Mailing Address - Country:US
Mailing Address - Phone:903-572-9823
Mailing Address - Fax:903-572-4812
Practice Address - Street 1:2001 N JEFFERSON AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-2386
Practice Address - Country:US
Practice Address - Phone:903-572-9823
Practice Address - Fax:903-572-4812
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX674253363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics