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Individual

ELLEN GARNER GASTAUER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
11937 US HIGHWAY 271, TYLER, TX 75708-3154
(903) 877-7777
Mailing address
PO BOX 731912, DALLAS, TX 75373-1912
(903) 877-7777

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
720673
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
720673
NURSE PRACTITIONER LICENS
TX
Enumeration date
08/19/2006
Last updated
11/30/2016
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