Provider Demographics
NPI:1699661447
Name:GONZALEZ, SARA L (FNP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14418 MIGUEL TERRAZAS
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-7308
Mailing Address - Country:US
Mailing Address - Phone:915-203-3283
Mailing Address - Fax:
Practice Address - Street 1:14418 MIGUEL TERRAZAS
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-7308
Practice Address - Country:US
Practice Address - Phone:915-203-3283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1204474207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine