Individual
GINA WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
5201 HARRY HINES BLVD, DALLAS, TX 75235-7708
(214) 590-8000
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
(214) 590-8382
(214) 590-2671
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
678458
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP678458
WORK COMP
TX
Enumeration date
11/12/2006
Last updated
11/20/2008
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