Provider Demographics
NPI:1710789953
Name:GONZALEZ, KATHLEEN R (CNA)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:R
Last Name:GONZALEZ
Suffix:
Gender:
Credentials:CNA
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:R
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA
Mailing Address - Street 1:5501 TEXAS ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77011-4347
Mailing Address - Country:US
Mailing Address - Phone:346-277-1185
Mailing Address - Fax:
Practice Address - Street 1:6200 N BRAESWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-7599
Practice Address - Country:US
Practice Address - Phone:713-778-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA0061036622376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide