Provider Demographics
NPI:1497101679
Name:GONZALEZ, AMANDA CHRISTINA (NP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:CHRISTINA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4511 HORIZON HILL BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2449
Mailing Address - Country:US
Mailing Address - Phone:210-477-2626
Mailing Address - Fax:210-477-2650
Practice Address - Street 1:4511 HORIZON HILL BLVD STE 150
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2449
Practice Address - Country:US
Practice Address - Phone:210-477-2626
Practice Address - Fax:210-477-2650
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130123363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner