Individual provider Active NPI

Sandra A Gonzalez, FNP

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1881999175
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP119843 Issued in TX
Practice address
9636 Mesa Dr
Kipp Building 9618
Houston, TX 77078-3024
Phone
(281) 628-2050
NPI assigned
Jan 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP119843 TX Primary
Registered Nurse 163W00000X 718237 TX

Addresses

Primary practice location

9636 Mesa Dr
Kipp Building 9618
Houston, TX 77078-3024

Mailing address

PO Box 66308
Houston, TX 77266-6308
Phone (832) 548-5000

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
I20110429000346 TX Practitioner - Nurse Practitioner 8729263157 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
718237TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Community Health Services, Inc CurrentSince Nov 12, 2014 Accepting new patients
Legacy Community Health Services, Inc CurrentSince Nov 12, 2014 Accepting new patients

Locations

9606 Mesa Dr
Houston, TX 77078
Phone (281) 879-3012

8805 Ferndale
Houston, TX 77017
Phone (832) 233-0417

13940 Bonham St
Houston, TX 77015
Phone (713) 330-8904

6441 High Star Dr
Houston, TX 77074
Phone (832) 548-5300

5400 Martin Luther King Blvd
Houston, TX 77021
Phone (210) 445-9952

10711 Kipp Way Dr
Houston, TX 77099
Phone (281) 628-2020

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1881999175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66308",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772666308",
            "telephone_number": "832-548-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9636 MESA DR",
            "address_2": "KIPP BUILDING 9618",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770783024",
            "telephone_number": "281-628-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "SANDRA",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-18",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP119843",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "718237",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.