Provider Demographics
NPI:1710593330
Name:PLAZA GONZALEZ, YANEXIS
Entity Type:Individual
Prefix:
First Name:YANEXIS
Middle Name:
Last Name:PLAZA 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 1:1155 DAIRY ASHFORD RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-3021
Mailing Address - Country:US
Mailing Address - Phone:713-799-2200
Mailing Address - Fax:
Practice Address - Street 1:6402 S GLENROCK HILLS CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-0444
Practice Address - Country:US
Practice Address - Phone:562-319-3280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY795532163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse