Provider Demographics
NPI:1730358490
Name:GONZALEZ, EVY C (FNP)
Entity type:Individual
Prefix:MRS
First Name:EVY
Middle Name:C
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 E 6TH STREET SUITE 10
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596
Mailing Address - Country:US
Mailing Address - Phone:956-447-9797
Mailing Address - Fax:956-447-9696
Practice Address - Street 1:1315 E 6TH STREET, SUITE 10
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596
Practice Address - Country:US
Practice Address - Phone:956-447-9797
Practice Address - Fax:956-447-9696
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX670594363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX349546702Medicaid
TXH088JK920OtherBCBS
TX349546701Medicaid