Provider Demographics
NPI:1871132811
Name:GONZALEZ, MONICA DEL BOSQUE
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:DEL BOSQUE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4325 OCEAN DR APT 3L
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-2511
Mailing Address - Country:US
Mailing Address - Phone:361-816-6927
Mailing Address - Fax:
Practice Address - Street 1:504A HOUSTON ST
Practice Address - Street 2:
Practice Address - City:GEORGE WEST
Practice Address - State:TX
Practice Address - Zip Code:78022-3663
Practice Address - Country:US
Practice Address - Phone:361-226-1219
Practice Address - Fax:361-447-1020
Is Sole Proprietor?:No
Enumeration Date:2019-12-21
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144421363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily