MEDICARE: CECILIA MARIE GONZALES FNP-C

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
1	363LF0000X	Family Nurse Practitioner	1231024	TX

General Provider Information

NPI Number	:	1548102643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CECILIA MARIE GONZALES FNP-C

Provider Business Mailing Address
First Line	:	10211 LEEDSCASTLE MANOR CT
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-7485
Country	:	US
Telephone Number	:	575-635-9254
Fax Number	:

Provider Business Practice Location Address
First Line	:	10211 LEEDSCASTLE MANOR CT
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-7485
Country	:	US
Telephone Number	:	575-635-9254
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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