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General NPI Number Information
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NPI Number | 1801414479
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Entity Type | Individual
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Provider Name | ELEALEH MAE GONZAGA MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/10/2020
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 2302 CORNERSTONE BLVD
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City | EDINBURG
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State | TX
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Zip | 78539-8471
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Country | US
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Telephone | 956-618-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 600 WICHITA AVE APT 508
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City | MCALLEN
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State | TX
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Zip | 78503-3042
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1002860
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License Number State | TX
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