Provider Demographics
NPI:1669753760
Name:GONZALEZ, ABIGAIL (RN, FNP)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 E SAUNDERS ST STE A300
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-5474
Mailing Address - Country:US
Mailing Address - Phone:956-728-8120
Mailing Address - Fax:956-728-8615
Practice Address - Street 1:105 S US HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076-3747
Practice Address - Country:US
Practice Address - Phone:956-751-1999
Practice Address - Fax:956-751-1998
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP120402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX312179ZR6KOtherMEDICARE
TXAP120402OtherLICENSE