Healthcare Provider Details

I. General information

NPI: 1285738724
Provider Name (Legal Business Name): DAVID GASKIN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 UNIVERSITY DR E STE 370
BRYAN TX
77802-3485
US

IV. Provider business mailing address

10592 COUNTY ROAD 175
IOLA TX
77861-3617
US

V. Phone/Fax

Practice location:
  • Phone: 979-703-1426
  • Fax: 979-709-1427
Mailing address:
  • Phone: 979-229-9188
  • Fax: 979-703-1426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License NumberAP106201
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number049819
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: