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General NPI Number Information
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NPI Number | 1710075841
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Entity Type | Organization
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Legal Business Name | VELMA GONZALEZ
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 619 E 9TH ST
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City | MISSION
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State | TX
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Zip | 78572-4205
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Country | US
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Telephone | 956-583-8085
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Fax | 956-583-0221
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Provider Business Mailing Address
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Address Line | PO BOX 3588
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City | MISSION
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State | TX
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Zip | 78573-0061
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Country | US
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Telephone | 956-583-8085
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Fax | 956-583-0221
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. CHARLIE DELEON
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Credential |
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Telephone | 956-583-8085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 108068
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License Number State | TX
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