Provider Demographics
NPI:1962642777
Name:GONZALEZ, MONICA ESPERANZA (PA)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:ESPERANZA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W SAM HOUSTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-5104
Mailing Address - Country:US
Mailing Address - Phone:956-609-6699
Mailing Address - Fax:956-609-6700
Practice Address - Street 1:1100 W SAM HOUSTON BLVD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-5104
Practice Address - Country:US
Practice Address - Phone:956-609-6699
Practice Address - Fax:956-609-6700
Is Sole Proprietor?:No
Enumeration Date:2009-03-06
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05847363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA05847OtherTEXAS LICENSE