Individual
GWENDOLYN CHAMPION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSA
Contact information
Practice address
4026 E TEAL ESTATES CIR, FRESNO, TX 77545
(510) 984-8610
Mailing address
4026 E TEAL ESTATES CIR, FRESNO, TX 77545-8851
(510) 984-8610
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
SA00547
—
Other
Enumeration date
03/30/2015
Last updated
04/30/2020
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