Individual
ELIZABETH GAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1035 HICKORY CREEK BLVD, HICKORY CREEK, TX 75065-7552
(713) 335-1745
Mailing address
2124 MILLWOOD DR, CORINTH, TX 76210-2218
(469) 441-6613
(940) 498-0112
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01853
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PAO1853
PA PERMIT
TX
Enumeration date
08/31/2006
Last updated
05/09/2008
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