Individual
GREGORY JAY VANGINAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3601 4TH ST, STE. 1C282, LUBBOCK, TX 79430-8182
(806) 743-2981
(806) 743-2984
Mailing address
PO BOX 5865, LUBBOCK, TX 79408-5865
(806) 743-2898
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
672045
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155776100
—
TX
01
—
155776101
FIRSTCARE COMMERCIAL
TX
05
—
200103950A
—
OK
01
—
87136U
BC BS
TX
01
—
87137U
HMO BLUE
TX
Enumeration date
01/24/2007
Last updated
12/09/2021
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