Provider Demographics
NPI:1033088943
Name:PRITACHRD GONZALEZ, EARL JAMES
Entity type:Individual
Prefix:
First Name:EARL
Middle Name:JAMES
Last Name:PRITACHRD GONZALEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 LIPAN ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78408-3820
Mailing Address - Country:US
Mailing Address - Phone:619-218-1999
Mailing Address - Fax:
Practice Address - Street 1:2621 LIPAN ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78408-3820
Practice Address - Country:US
Practice Address - Phone:619-218-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-30
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program