Individual
MARY ELLEN GANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3205 W DAVIS ST, SUITE B 150, CONROE, TX 77304-2039
(936) 756-6661
(936) 756-6681
Mailing address
3205 W DAVIS ST, SUITE B 150, CONROE, TX 77304-2039
(936) 756-6661
(936) 756-6681
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA02408
TX
Other
Enumeration date
11/01/2006
Last updated
02/25/2008
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