Provider Demographics
NPI:1245565787
Name:GONZALEZ, ELIZABETH A (LBSW)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:A
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LBSW
Mailing Address - Street 1:807 N. CAGE
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-3187
Mailing Address - Country:US
Mailing Address - Phone:956-283-1889
Mailing Address - Fax:956-283-7014
Practice Address - Street 1:807 N CAGE BLVD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-3117
Practice Address - Country:US
Practice Address - Phone:956-283-1889
Practice Address - Fax:956-283-7014
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27826171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator