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Individual

CHRISTINE GONZALES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN, NP-C

Contact information

Practice address
12564 LIBERTY SCHOOL RD, AZLE, TX 76020-5630
(817) 381-2143
Mailing address
12564 LIBERTY SCHOOL RD, AZLE, TX 76020-5630

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1025398
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16159701
CASH PAY
TX
Enumeration date
05/10/2021
Last updated
05/10/2021
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