Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | R2858 | TX |
NPI | 1003222787 |
---|---|
Provider Name | Christian Gonzalez |
First Address | Harlingen, TX 78553-4358 |
Second Address | Harlingen, TX 78550-8307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2014 |
Last Update Date | 22/04/2019 |