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NPI Code Detail

MEDICARE: DEBORAH A GONZALEZ APRN, BC, NP-C

MEDICARE:   DEBORAH A GONZALEZ  APRN, BC, NP-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
1363LF0000XFamily Nurse PractitionerF1107064TX
2363LF0000XFamily Nurse Practitioner702062TX

General Provider Information

NPI Number : 1669640884
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH A GONZALEZ APRN, BC, NP-C
Provider Business Mailing Address
First Line : 6428 BANDERA RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78238-1511
Country : US
Telephone Number : 210-520-4455
Fax Number : 210-520-4421
Provider Business Practice Location Address
First Line : 6428 BANDERA RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78238-1511
Country : US
Telephone Number : 210-520-4455
Fax Number : 210-520-4421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2008
Last Update Date : 03/19/2012

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Directions to “ DEBORAH A GONZALEZ APRN, BC, NP-C” Practice Location

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