Healthcare Provider Details

I. General information

NPI: 1316451081
Provider Name (Legal Business Name): ANNETTE ROMERO GONZALEZ FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2017
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5115 EL PASO DR STE B
EL PASO TX
79905-2818
US

IV. Provider business mailing address

5115 EL PASO DR STE B
EL PASO TX
79905-2818
US

V. Phone/Fax

Practice location:
  • Phone: 915-212-6609
  • Fax: 915-212-0172
Mailing address:
  • Phone: 915-212-6609
  • Fax: 915-212-0172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP135534
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: