Provider Demographics
NPI:1265787030
Name:GONZALEZ, SUSSY A (RNFA, ANP-C)
Entity type:Individual
Prefix:
First Name:SUSSY
Middle Name:A
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:RNFA, ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6400 FANNIN ST STE 1700
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1526
Mailing Address - Country:US
Mailing Address - Phone:713-486-6000
Mailing Address - Fax:713-486-6049
Practice Address - Street 1:10905 MEMORIAL HERMANN DR STE 130
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3773
Practice Address - Country:US
Practice Address - Phone:713-486-6000
Practice Address - Fax:713-486-6000
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX707614163WR0006X, 363LA2200X
COC-APN.0000215-C-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant