Individual
JOEL E. GANGROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
3414 GOLDEN RD, TYLER, TX 75701-8336
(903) 939-7500
(903) 597-1245
Mailing address
12002 COUNTY ROAD 4401, LARUE, TX 75770-6101
(903) 830-0604
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AT2040
TX
Other
Enumeration date
06/21/2007
Last updated
07/08/2007
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