Provider Demographics
NPI:1821106964
Name:GONZALEZ, ALVARO GONZALES III (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:ALVARO
Middle Name:GONZALES
Last Name:GONZALEZ
Suffix:III
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1725 BROWN ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4726
Mailing Address - Country:US
Mailing Address - Phone:915-590-2225
Mailing Address - Fax:915-590-2229
Practice Address - Street 1:1725 BROWN ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4726
Practice Address - Country:US
Practice Address - Phone:915-590-2225
Practice Address - Fax:915-590-2229
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0706310363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188648301Medicaid
TX8J3401Medicare PIN