Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 22520 | TX |
Y | 103TC0700X | Clinical Psychologist | 22520 | TX |
NPI | 1003876855 |
---|---|
Provider Name | Dr. Gary R. Elkins |
First Address | Temple, TX 76504-6867 |
Second Address | Temple, TX 76504-6867 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 02/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0041NU | BCBS OF TEXAS (01) | TX |
040065701 | (05) | TX |
1003876855 | AETNA (01) | |
1003876855 | MAGELLAN (01) | |
1003876855 | SCOTT AND WHITE HEALTH PL (01) | TX |
613034 | (02) | TX |