Individual
MR. GERALD EDWARD SHOUSE II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 525-2668
Mailing address
3454 VILLA AVE, SHREVEPORT, LA 71107-7721
(318) 208-6200
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
211335
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
1180657
TX
Other
Enumeration date
12/11/2023
Last updated
02/12/2025
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