Jimenez, Gonzalo

Jimenez, Gonzalo is an sole proprietor health care provider with primary practice located at 1901 S 24Th Ave , Edinburg TX 78539-6533. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Jimenez, Gonzalo can be contacted via phone (956) 289-7000.

Contact Information

Primary practice address
1901 S 24Th Ave Edinburg TX 78539-6533
Phone: (956) 289-7000
Fax: (956) 289-7257
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 01542 Texas

Profile Details

NPI number 1720184708
LBN Legal business name Jimenez, Gonzalo
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 16th, 2006
Last updated Aug 6th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720184708 NPPES
Texas Other 00R945 MEDICARE
Texas MEDICAID 138708611 MEDICARE
Texas MEDICAID 138708613 MEDICARE

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