Provider Demographics
NPI:1639588825
Name:GONZALEZS, NORMA
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:GONZALEZS
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:PO BOX 2641
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-0044
Mailing Address - Country:US
Mailing Address - Phone:956-890-9667
Mailing Address - Fax:361-356-4304
Practice Address - Street 1:3702 CANDO MUNGIA
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-1550
Practice Address - Country:US
Practice Address - Phone:956-240-2251
Practice Address - Fax:361-356-4304
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX715397146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant