Provider Demographics
NPI:1083256879
Name:GONZALEZ, SARITA (FNP)
Entity Type:Individual
Prefix:
First Name:SARITA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8919 N 32ND LN
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-5975
Mailing Address - Country:US
Mailing Address - Phone:956-655-9561
Mailing Address - Fax:
Practice Address - Street 1:210 S BRYAN RD
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-6204
Practice Address - Country:US
Practice Address - Phone:956-585-6611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-13
Last Update Date:2019-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141495363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner