Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 502406 | TX |
NPI | 1033275136 |
---|---|
Provider Name | Mrs. Linda Gail Langston |
First Address | Duncanville, TX 75137-4018 |
Second Address | Mansfield, TX 76063 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P43183 | (02) | TX |