Healthcare Provider Details

I. General information

NPI: 1033027909
Provider Name (Legal Business Name): CLARISA GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 ERIE AVE
MCALLEN TX
78501-4907
US

IV. Provider business mailing address

1217 ERIE AVE
MCALLEN TX
78501-4907
US

V. Phone/Fax

Practice location:
  • Phone: 956-680-0267
  • Fax: 956-627-3558
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: