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NPI Code Detail

MEDICARE: JOSEFINA GONZALEZ

MEDICARE: JOSEFINA GONZALEZ
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1497256416
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEFINA GONZALEZ
Provider Business Mailing Address
First Line : 2809 W SHADY GROVE RD
Second Line :
City : IRVING
State : TX
Zip : 75060-4958
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2809 W SHADY GROVE RD
Second Line :
City : IRVING
State : TX
Zip : 75060-4958
Country : US
Telephone Number : 972-400-1280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2018
Last Update Date : 02/25/2018

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