MEDICARE: MARIE ANN GONZALES-ESPARZA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251J00000X	Nursing Care Agency
2	376K00000X	Nurse's Aide
3	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1578123196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE ANN GONZALES-ESPARZA

Provider Business Mailing Address
First Line	:	12419 NEWBROOK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-3911
Country	:	US
Telephone Number	:	346-357-5009
Fax Number	:

Provider Business Practice Location Address
First Line	:	12419 NEWBROOK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-3911
Country	:	US
Telephone Number	:	463-575-0093
Fax Number	:

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

Provider Enumeration Date	:	06/17/2019
Last Update Date	:	06/17/2019

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