Individual
KENNETH R GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
711 W 38TH ST STE E4, AUSTIN, TX 78705-1132
(512) 768-0652
Mailing address
116 RED CAMELLA DR, GEORGETOWN, TX 78628-3963
(512) 948-0850
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
672092
TX
Other
Enumeration date
07/11/2015
Last updated
09/16/2025
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