Individual
MRS. MYRIAM GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
10710 MCPHERSON RD STE 300, LAREDO, TX 78045-6411
(956) 794-8853
(956) 795-4744
Mailing address
PO BOX 3046, MALVERN, PA 19355-0746
(956) 794-8853
(956) 795-4744
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP127049
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
342275001
—
TX
01
—
8990NM
BCBS
TX
Enumeration date
12/11/2014
Last updated
07/21/2022
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