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NPI Code Detail

MEDICARE: JULIA GONZALEZ

MEDICARE: JULIA GONZALEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1246Z00000XOther Specialist/Technologist

General Provider Information

NPI Number : 1194543975
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA GONZALEZ
Provider Business Mailing Address
First Line : 18511 HIGHLANDER MEDICS ST
Second Line :
City : FORT BLISS
State : TX
Zip : 79906-5327
Country : US
Telephone Number : 915-742-1321
Fax Number :
Provider Business Practice Location Address
First Line : 11335 SSG SIMS ST
Second Line :
City : FORT BLISS
State : TX
Zip : 79918-8033
Country : US
Telephone Number : 915-742-1321
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2024
Last Update Date : 09/30/2024

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Directions to “ JULIA GONZALEZ ” Practice Location

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