Individual
GARY P ENGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Mailing address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
J1988
TX
207RH0003X
Hematology & Oncology Physician
Primary
J1988
TX
207RX0202X
Medical Oncology Physician
J1988
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043953101
—
TX
05
—
131935001
—
AR
Enumeration date
07/28/2005
Last updated
04/24/2024
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