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NPI Code Detail

MEDICARE: MRS. IRASEMA GONZALEZ FNP-BC

MEDICARE: MRS. IRASEMA GONZALEZ FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner693173TX

General Provider Information

NPI Number : 1023399169
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. IRASEMA GONZALEZ FNP-BC
Provider Business Mailing Address
First Line : PO BOX 749
Second Line :
City : PHARR
State : TX
Zip : 78577-1614
Country : US
Telephone Number : 956-362-2171
Fax Number : 956-378-9376
Provider Business Practice Location Address
First Line : 1601 E SPRAGUE ST
Second Line :
City : EDINBURG
State : TX
Zip : 78542-5260
Country : US
Telephone Number : 956-378-9290
Fax Number : 956-378-9376
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2011
Last Update Date : 01/19/2017

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