Individual
KATYA MAILLARD-GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-1024
(254) 724-8800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01068842A
IN
207QG0300X
Geriatric Medicine (Family Medicine) Physician
01068842A
IN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
Q0500
TX
Other
Enumeration date
05/23/2008
Last updated
01/27/2022
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