Individual
GREGORY R PENDERGAST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
901 HIDDEN VALLEY DR APT 6302, ROUND ROCK, TX 78665-1475
(817) 932-4285
Mailing address
901 HIDDEN VALLEY DR APT 6302, ROUND ROCK, TX 78665-1475
(817) 932-4285
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT6282
TX
Other
Enumeration date
11/20/2020
Last updated
12/09/2021
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