Provider Demographics
NPI:1740680024
Name:GONZALES, LINDA ANN
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ANN
Last Name:GONZALES
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 1:805 I-30
Mailing Address - Street 2:APT. 317
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-1415
Mailing Address - Country:US
Mailing Address - Phone:214-646-7933
Mailing Address - Fax:214-594-9029
Practice Address - Street 1:805 I-30
Practice Address - Street 2:APT. 317
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-1415
Practice Address - Country:US
Practice Address - Phone:214-646-7933
Practice Address - Fax:214-594-9029
Is Sole Proprietor?:No
Enumeration Date:2014-08-24
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator