Provider Demographics
NPI:1578123196
Name:GONZALES-ESPARZA, MARIE ANN
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:ANN
Last Name:GONZALES-ESPARZA
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 1:12419 NEWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-3911
Mailing Address - Country:US
Mailing Address - Phone:346-357-5009
Mailing Address - Fax:
Practice Address - Street 1:12419 NEWBROOK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-3911
Practice Address - Country:US
Practice Address - Phone:463-575-0093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
No376K00000XNursing Service Related ProvidersNurse's Aide