Active NPI
Wanda C Gonzalez, PHARMD
- Pharmacist
- Tulsa, OK
National Provider Identifier
1164708715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15052
- Practice address
- 11332 E 31St St
Tulsa, OK 74146-1905 - Phone
- (918) 622-9684
- NPI assigned
- Oct 27, 2011
- Last updated
- Oct 27, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15052 | OK | Primary |
Addresses
Primary practice location
11332 E 31St St
Tulsa, OK 74146-1905
Mailing address
11332 E 31St St
Tulsa, OK 74146-1905
Phone (918) 622-9684
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
- Credentials
- Doctor of Pharmacy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319673600000",
"number": "1164708715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11332 E 31ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741461905",
"telephone_number": "918-622-9684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11332 E 31ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741461905",
"telephone_number": "918-622-9684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "WANDA",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-27",
"last_updated": "2011-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "15052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.