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Individual

GINA FERGUSON-LOGI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
901 HEMPHILL, FORT WORTH, TX 76104-3111
(817) 332-4060
(817) 332-2304
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 332-2304

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
51244
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7910202
AETNA
TX
01
80331A
BLUE CROSS BLUE SHIELD
TX
Enumeration date
03/09/2007
Last updated
03/10/2017
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