Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | ||
Y | 2251P0200X | Physical Therapist - Pediatrics |
NPI | 1134697915 |
---|---|
Provider Name | Dr. Stuart M Gagie |
First Address | The Woodlands, TX 77384-4972 |
Second Address | The Woodlands, TX 77384-4972 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2018 |
Last Update Date | 09/11/2018 |