Individual
AUDREY GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
3230 INTERSTATE 30 STE 100, MESQUITE, TX 75150-2662
(972) 682-1791
Mailing address
2446 CATHERINE ST, DALLAS, TX 75211-5325
(832) 607-0486
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA11807
TX
Other
Enumeration date
03/01/2018
Last updated
03/01/2018
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