Provider Demographics
NPI:1447033865
Name:GONZALEZ, MARCO (MS)
Entity type:Individual
Prefix:MR
First Name:MARCO
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 RINCON RD
Mailing Address - Street 2:
Mailing Address - City:ROMA
Mailing Address - State:TX
Mailing Address - Zip Code:78584-6669
Mailing Address - Country:US
Mailing Address - Phone:956-844-4312
Mailing Address - Fax:
Practice Address - Street 1:118 RINCON RD
Practice Address - Street 2:
Practice Address - City:ROMA
Practice Address - State:TX
Practice Address - Zip Code:78584-6669
Practice Address - Country:US
Practice Address - Phone:956-844-4312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health