Provider Demographics
NPI:1538619267
Name:GONZALES, FRANK RAYMOND JR (FNP)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:RAYMOND
Last Name:GONZALES
Suffix:JR
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 77TH PL
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2452
Mailing Address - Country:US
Mailing Address - Phone:806-535-4395
Mailing Address - Fax:
Practice Address - Street 1:1915 77TH PL
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2452
Practice Address - Country:US
Practice Address - Phone:806-535-4395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-03522363LF0000X
TXAP132122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily