Active NPI
Angelica Brooke Gonzalez
- Occupational Therapist
- Laredo, TX
National Provider Identifier
1073387015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 124183
- Practice address
- 5702 McPherson Rd Ste 15
Laredo, TX 78041-6884 - Phone
- (956) 725-4555
- NPI assigned
- Nov 9, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 124183 | TX | Primary |
Addresses
Primary practice location
5702 McPherson Rd Ste 15
Laredo, TX 78041-6884
Mailing address
5702 McPherson Rd Ste 15
Laredo, TX 78041-6884
Phone (956) 725-4555
Other practice location 1
615A Gale St
Laredo, TX 78041-5955
Phone (956) 712-9988
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124183 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699488000000",
"number": "1073387015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5702 MCPHERSON RD STE 15",
"city": "LAREDO",
"state": "TX",
"postal_code": "780416884",
"telephone_number": "956-725-4555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5702 MCPHERSON RD STE 15",
"city": "LAREDO",
"state": "TX",
"postal_code": "780416884",
"telephone_number": "956-725-4555"
}
],
"practiceLocations": [
{
"address_1": "615A Gale St",
"address_purpose": "LOCATION",
"city": "Laredo",
"state": "TX",
"postal_code": "780415955",
"country_code": "US",
"telephone_number": "956-712-9988",
"fax_number": "956-791-4888",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GONZALEZ",
"first_name": "ANGELICA",
"middle_name": "BROOKE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-09",
"last_updated": "2023-11-09",
"certification_date": "2023-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "124183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laredo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.