Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 1003514 | TX |
N | 363LW0102X | Nurse Practitioner - Women's Health | 1003514 | TX |
NPI | 1336771419 |
---|---|
Provider Name | Mrs. Katie Gaston |
First Address | Mckinney, TX 75071-7600 |
Second Address | Mckinney, TX 75071-7600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2020 |
Last Update Date | 18/08/2021 |