Individual
ELISA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
6977 MAIN ST, HOUSTON, TX 77030-3701
(713) 793-3780
(713) 793-3779
Mailing address
1985 KINGSTON CV, LEAGUE CITY, TX 77573-4988
(713) 828-6480
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA02845
TX
Other
Enumeration date
09/02/2020
Last updated
09/30/2020
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