Active NPI
Nancy Gonzalez
- Occupational Therapy Assistant
- Tolar, TX
National Provider Identifier
1780246090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 211844
- Practice address
- 5702 Friendship Rd
Tolar, TX 76476-5390 - Phone
- (214) 734-0094
- NPI assigned
- Jul 8, 2019
- Last updated
- Jul 8, 2019
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 211844 | TX | Primary |
Addresses
Primary practice location
5702 Friendship Rd
Tolar, TX 76476-5390
Mailing address
1030 E Hwy 377 Ste 110-177
Granbury, TX 76048-1456
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 |
|---|---|---|---|
| 211844 | TX | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562544000000",
"number": "1780246090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1030 E HWY 377 STE 110-177",
"city": "GRANBURY",
"state": "TX",
"postal_code": "760481456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5702 FRIENDSHIP RD",
"city": "TOLAR",
"state": "TX",
"postal_code": "764765390",
"telephone_number": "214-734-0094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "NANCY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-08",
"last_updated": "2019-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "211844",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tolar, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.