Individual
ALICIA GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
929 GRAHAM DR, SUITE B, TOMBALL, TX 77375-6451
(281) 351-5548
(281) 351-5020
Mailing address
929 GRAHAM DR, SUITE B, TOMBALL, TX 77375-6451
(281) 351-5548
(281) 351-5020
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA08491
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA08491
STATE
TX
Enumeration date
07/29/2013
Last updated
09/24/2014
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