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Individual
VANESSA GONZALES MARTINEZ
Active
Individual
VANESSA GONZALES MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP139825
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
398943601
—
TX
01
—
813835
MEDICARE LINKED TO PROVIDENCE MEDICAL
TX
01
—
8KZ207
SOLO BCBS
TX
01
—
P02274362
RR MEDICARE
TX
Enumeration date
03/12/2019
Last updated
09/26/2019
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