Active NPI
Gloria Gonzalez
- Speech-Language Assistant
- College Station, TX
National Provider Identifier
1093443632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 42382
- Practice address
- 1220 Boswell St
College Station, TX 77840-4308 - Phone
- (979) 764-5580
- NPI assigned
- Aug 11, 2022
- 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 |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 42382 | TX | Primary |
Addresses
Primary practice location
1220 Boswell St
College Station, TX 77840-4308
Mailing address
1812 Welsh Ave
College Station, TX 77840-4800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42382 | Other | TX | TEXAS DEPARTMENT OF LICENSING AND REGULATION |
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 |
|---|---|---|---|
| 42382 | TX | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660176000000",
"number": "1093443632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1812 WELSH AVE",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778404800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 BOSWELL ST",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778404308",
"telephone_number": "979-764-5580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "GLORIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-11",
"last_updated": "2022-08-11",
"certification_date": "2022-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "TX",
"license": "42382",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS DEPARTMENT OF LICENSING AND REGULATION",
"identifier": "42382",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in College Station, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.