Healthcare Provider Details

I. General information

NPI: 1003127317
Provider Name (Legal Business Name): RHONDA G GELBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 01/29/2021
Certification Date: 01/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 W KINGSLEY RD STE 336
GARLAND TX
75041-3434
US

IV. Provider business mailing address

219 W KINGSLEY RD STE 336
GARLAND TX
75041-3434
US

V. Phone/Fax

Practice location:
  • Phone: 972-271-5544
  • Fax: 972-271-5567
Mailing address:
  • Phone: 972-271-5544
  • Fax: 972-271-5567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA00969
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: