Provider Demographics
NPI:1972577260
Name:GONZALEZ, LOIS W (PHD, APRN)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:W
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PHD, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 W FRANK AVE
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3520
Mailing Address - Country:US
Mailing Address - Phone:936-637-7600
Mailing Address - Fax:936-637-4990
Practice Address - Street 1:2301 W FRANK AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3520
Practice Address - Country:US
Practice Address - Phone:936-637-7600
Practice Address - Fax:936-637-4990
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10486101YM0800X
TX000462-041982106H00000X
TX225094363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health