Provider Demographics
NPI:1871157800
Name:GONZALEZ, DEBORAH ANNETTE
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANNETTE
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 1:130 SUNSET VILLA DR
Mailing Address - Street 2:
Mailing Address - City:ZAPATA
Mailing Address - State:TX
Mailing Address - Zip Code:78076-2505
Mailing Address - Country:US
Mailing Address - Phone:956-847-6344
Mailing Address - Fax:
Practice Address - Street 1:102 1ST AVE STE B
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076-4282
Practice Address - Country:US
Practice Address - Phone:956-847-6344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2021-04-12
Deactivation Date:2019-09-30
Deactivation Code:
Reactivation Date:2021-04-12
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies