Individual
JACQUELINE GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3721 WILLIAMS DR, GEORGETOWN, TX 78628-2401
(512) 869-7310
Mailing address
3721 WILLIAMS DR, GEORGETOWN, TX 78628-2401
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PATEMP
TX
363AS0400X
Surgical Physician Assistant
Primary
TEMPORARY
TX
Other
Enumeration date
06/23/2021
Last updated
09/20/2021
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