Provider Demographics
NPI:1508006602
Name:GONZALEZ, BELVA J (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:BELVA
Middle Name:J
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 ZACATECAS ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-6814
Mailing Address - Country:US
Mailing Address - Phone:956-718-6810
Mailing Address - Fax:
Practice Address - Street 1:2500 ZACATECAS ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-6814
Practice Address - Country:US
Practice Address - Phone:956-718-6810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX500278363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily