Individual
RANDY GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN,FNP-C
Contact information
Practice address
7133 OCONNELL ST, ROCKWALL, TX 75087-7033
(469) 766-1094
Mailing address
7133 OCONNELL ST, ROCKWALL, TX 75087-7033
(469) 766-1094
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
651184
TX
Other
Enumeration date
10/23/2009
Last updated
10/23/2009
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