Basic Information
| Provider Information | |||||||||
| NPI: | 1356089924 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GONZALEZ | ||||||||
| FirstName: | ALEXANDRA | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1790 MERCER PKWY APT 11110 | ||||||||
| Address2: | |||||||||
| City: | FARMERS BRANCH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752341463 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2144994621 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8403 SH 151 STE 108 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782452055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2109984790 | ||||||||
| FaxNumber: | 2109984791 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2022 | ||||||||
| LastUpdateDate: | 09/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | F04220508 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 1086366 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.