Gonzalez, Edgardo Mauricio

Gonzalez, Edgardo Mauricio is an individual health care provider with primary practice located at 17201 Interstate 45 S , Shenandoah TX 77385-3311. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Technologists, Technicians & Other Technical Service Providers / Surgical Assistant. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Gonzalez, Edgardo Mauricio can be contacted via phone (305) 610-0506.

Contact Information

Primary practice address
17201 Interstate 45 S Shenandoah TX 77385-3311
Phone: (305) 610-0506
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X
Technologists, Technicians & Other Technical Service Providers / Surgical Assistant 246ZC0007X 16-165 Wisconsin

Profile Details

NPI number 1982058053
LBN Legal business name Gonzalez, Edgardo Mauricio
Credentials CSA, LSA
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2016
Last updated Dec 5th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982058053 NPPES
Texas Other SA00743 MEDICAL BOARD OF TEXAS
Texas Other 16-165 MEDICAL BOARD OF TEXAS

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