Individual
PORTIA GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
528 LARIAT DR, DENISON, TX 75021-4198
(903) 647-5209
Mailing address
528 LARIAT DR, DENISON, TX 75021-4198
(903) 647-5209
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
750455
TX
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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