Nancy Gonzalez
Individual provider Active NPI Occupational Therapy Assistant · Tolar, TX
NPI 1780246090 · NPPES record last updated Jul 8, 2019
Key facts
- NPI
- 1780246090
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 211844 (TX)
- Practice address
- 5702 Friendship Rd
Tolar, TX 76476-5390 - Phone
- (214) 734-0094
- NPI assigned
- Jul 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 211844 | TX | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 211844 | TX | Yes |
Addresses
Primary practice location
5702 Friendship Rd
Tolar, TX 76476-5390
Mailing address
1030 E Hwy 377 Ste 110-177
Granbury, TX 76048-1456
Other providers in Tolar, TX
- Robbie L Davis
- Tristan Michael Hawkins
- Jared Ives
- Lab Testing Near Me LLC
- Glenn Newberry
- Abel Abrego Salas Sr.
All providers in Tolar, TX · Occupational Therapy 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 Jul 8, 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.