Provider Demographics
NPI:1750051959
Name:GONZALEZ, ANA GABRIELA (RD,LD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:GABRIELA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 N 16TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-7984
Mailing Address - Country:US
Mailing Address - Phone:956-655-8007
Mailing Address - Fax:
Practice Address - Street 1:214 N 16TH ST STE 125
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-7984
Practice Address - Country:US
Practice Address - Phone:956-655-8007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-18
Last Update Date:2021-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT84268133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered