Individual
CARLY S GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210
(760) 803-4011
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
Q2283
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
347741606
—
TX
Enumeration date
05/29/2009
Last updated
06/14/2016
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