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Individual
ETHAN DAVID GAGER
Active
Individual
ETHAN DAVID GAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
907598
MS
363LF0000X
Family Nurse Practitioner
Primary
95034313
CA
363LP2300X
Primary Care Nurse Practitioner
AP139837
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2143855920
—
TX
Enumeration date
09/16/2019
Last updated
07/17/2025
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