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General NPI Number Information
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NPI Number | 1942769351
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Entity Type | Individual
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Provider Name | SABRINA ANN GONZALES BS, ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 03/15/2019
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 1 OWL SQ
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City | ODEM
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State | TX
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Zip | 78370-4388
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Country | US
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Telephone | 361-368-8121
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Fax |
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Provider Business Mailing Address
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Address Line | 6301 MEADOWVISTA DR APT 837
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City | CORPUS CHRISTI
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State | TX
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Zip | 78414-2637
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT7941
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License Number State | TX
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