Individual
MS. TINA LOUISE GORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1170 COLORADO DR, WAXAHACHIE, TX 75167-8199
(972) 938-2316
(972) 937-8780
Mailing address
1170 COLORADO DR, WAXAHACHIE, TX 75167-8199
(972) 938-8780
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MT104092
TX
Other
Enumeration date
11/23/2007
Last updated
11/23/2007
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