Jacquelyn Gonzalez
Individual provider Active NPI Speech-Language Assistant · Roma, TX
NPI 1164061917 · NPPES record last updated Dec 26, 2019
Key facts
- NPI
- 1164061917
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Assistant 2355S0801X
- License
- 40772 (TX)
- Practice address
- 700 E Bravo Blvd Ste D
Roma, TX 78584-5741 - Phone
- (956) 849-1818
- NPI assigned
- Dec 26, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40772 | TX | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 40772 | TX | Yes |
Addresses
Primary practice location
700 E Bravo Blvd Ste D
Roma, TX 78584-5741
Mailing address
2108 S M St
McAllen, TX 78503-1555
Other providers in Roma, TX
- Joann Garza
- Gold Starr Rehabilitation Center, Inc,
- Gold Starr Rehabilitation Center, Inc.
- Celina Yvette Gonzalez
- Christian Gonzalez
- Marco Gonzalez
- Daisy L Guerra
- Felipe Onesimo Hinojosa
- Jaac Health Care LLC
- La Paloma DME,LLC
All providers in Roma, TX · Speech-Language Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.