Provider Demographics
NPI:1568962561
Name:GONZALEZ, DOROTHY ANN
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:ANN
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 WINDMILL LN
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-6123
Mailing Address - Country:US
Mailing Address - Phone:214-364-7612
Mailing Address - Fax:
Practice Address - Street 1:1008 WINDMILL LN
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-6123
Practice Address - Country:US
Practice Address - Phone:214-364-7612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX928700163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse