Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 689640 | TX |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP115917 | TX |
NPI | 1023249737 |
---|---|
Provider Name | Amy Cathleen Gonzalez |
First Address | San Antonio, TX 78207-3011 |
Second Address | San Antonio, TX 78207-3011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2009 |
Last Update Date | 08/08/2017 |