Provider Demographics
NPI:1033917125
Name:GONZALES, NANCY LEE (PMHNP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:LEE
Last Name:GONZALES
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:LEE
Other - Last Name:GONZALES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP
Mailing Address - Street 1:211 LEMUR DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-3436
Mailing Address - Country:US
Mailing Address - Phone:210-837-3907
Mailing Address - Fax:
Practice Address - Street 1:10410 DOHERTY SPG
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78255-1041
Practice Address - Country:US
Practice Address - Phone:210-395-4520
Practice Address - Fax:210-395-4521
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1192216363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty