Provider Demographics
NPI:1982278800
Name:GONZALEZ, LEYANIS (APRN-FNP)
Entity type:Individual
Prefix:DR
First Name:LEYANIS
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:DR
Other - First Name:LEYANIS
Other - Middle Name:GONZALEZ
Other - Last Name:GONZALEZ GONZALEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:21114 SIERRA BEND DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-5700
Mailing Address - Country:US
Mailing Address - Phone:832-931-7131
Mailing Address - Fax:
Practice Address - Street 1:21114 SIERRA BEND DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-5700
Practice Address - Country:US
Practice Address - Phone:832-931-7131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-15
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX953880163W00000X
TX1036356363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse