Individual provider Active NPI

Alexandra Selena Gonzalez

  • Speech-Language Pathologist
  • El Paso, TX
National Provider Identifier
1972076008
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14292367 Issued in TX
Practice address
10450 Brian Mooney Ave
El Paso, TX 79935-2809
Phone
(915) 598-6616
NPI assigned
Jan 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 14292367 TX Primary

Addresses

Primary practice location

10450 Brian Mooney Ave
El Paso, TX 79935-2809

Mailing address

12293 Kingsgate CT
El Paso, TX 79928-7260

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

LicenseStateTypeSpecialty
14292367TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1972076008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12293 KINGSGATE CT",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799287260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 BRIAN MOONEY AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799352809",
            "telephone_number": "915-598-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ALEXANDRA",
        "middle_name": "SELENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "14292367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.

Verify at the official NPI Registry.