Individual provider Active NPI

Katrina Mae C Gonzales, NP

  • Pediatric Nurse Practitioner
  • Houston, TX
National Provider Identifier
1386412963
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1046789 Issued in TX
Practice address
1515 Holcombe Blvd
Houston, TX 77030-4000
Phone
(713) 792-6161
NPI assigned
Dec 13, 2023
Last updated
Dec 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1046789 TX Primary

Addresses

Primary practice location

1515 Holcombe Blvd
Houston, TX 77030-4000

Mailing address

P O Box 4439
Houston, TX 77210-4439
Phone (713) 792-2991

Other names 1

  • Katrina Mae V Calungsod Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211003009 TX Practitioner - Nurse Practitioner 5395271597 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1046789TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Aug 1, 2025 Accepting new patients
Physicians Referral Service CurrentSince Nov 20, 2024 Accepting new patients
Ut Physicians CurrentSince Aug 1, 2025 Accepting new patients
Texas Children's Physician Group CurrentSince Oct 27, 2025 Accepting new patients

Locations

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

1515 Holcombe Blvd
#M
Houston, TX 77030
Phone (713) 792-6127

1515 Holcombe Blvd
#R4212
Houston, TX 77030
Phone (713) 794-5446

6410 Fannin St
#135
Houston, TX 77030

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6621 Fannin St
Ste 2210
Houston, TX 77030
Phone (832) 824-2000

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

Organizations & group practices 4

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": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1386412963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 4439",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104439",
            "telephone_number": "713-792-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304000",
            "telephone_number": "713-792-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "KATRINA MAE",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-13",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1046789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATRINA MAE",
            "last_name": "CALUNGSOD",
            "middle_name": "V",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.