MEDICARE: MARIA Z GONZALEZ SLP

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
1	235Z00000X	Speech-Language Pathologist	14018	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609502848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA Z GONZALEZ SLP

Provider Business Mailing Address
First Line	:	410 E SAN PATRICIO AVE
Second Line	:
City	:	MATHIS
State	:	TX
Zip	:	78368-2352
Country	:	US
Telephone Number	:	361-547-4123
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 E SAN PATRICIO AVE
Second Line	:
City	:	MATHIS
State	:	TX
Zip	:	78368-2352
Country	:	US
Telephone Number	:	361-547-4123
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2022
Last Update Date	:	07/29/2022

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Directions to “ MARIA Z GONZALEZ SLP” Practice Location

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