Sandra M Gonzalez

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164006804 Issued in IL

Practice address

325 N Saint Paul St Ste 3100
Dallas, TX 75201-3923

Phone

(646) 389-3893

NPI assigned

Sep 28, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1336863893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5147 S HARDING AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606323710",
            "telephone_number": "773-757-2768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N SAINT PAUL ST STE 3100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752013923",
            "telephone_number": "646-389-3893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "SANDRA",
        "middle_name": "M",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164006804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar Gonzalez, OD
• Pablo Gonzalez, RPH
• Roberto Gonzalez
• Roberto Gonzalez, MS, RD, LD, CDE
• Ruben David Gonzalez, M.D.
• Victor Gonzalez, M.D.
• Victoria Gonzalez
• Victoria Gonzalez, DPT
• Viviana Gonzalez
• Viviana Gonzalez, OD

• Registered Dietitian in Dallas, TX
• Providers in Dallas, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.

Verify at the official NPI Registry.