Individual
AMY GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
10345 ALTA VISTA RD, FORT WORTH, TX 76244-6501
(817) 909-8558
Mailing address
PO BOX 163651, FORT WORTH, TX 76161-3651
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1035578
TX
133V00000X
Registered Dietitian
DT81618
TX
Other
Enumeration date
11/21/2015
Last updated
11/21/2015
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