Healthcare Provider Details

I. General information

NPI: 1962413138
Provider Name (Legal Business Name): GAYLE M. KARAMANOS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 S LANCASTER RD
DALLAS TX
75216-7167
US

IV. Provider business mailing address

6943 SANTA FE AVE
DALLAS TX
75223-1124
US

V. Phone/Fax

Practice location:
  • Phone: 214-857-1751
  • Fax: 214-857-1712
Mailing address:
  • Phone: 214-328-8538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA02667
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: