Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 1447 | TX |
N | 222Z00000X | Podiatrist | 1447 | TX |
Y | 224P00000X | Prosthetist | 1447 | TX |
NPI | 1326398710 |
---|---|
Provider Name | Christina Gambrell |
First Address | Round Rock, TX 78665-1023 |
Second Address | Round Rock, TX 78665-1023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2012 |
Last Update Date | 13/09/2012 |