Healthcare Provider Details

I. General information

NPI: 1063663946
Provider Name (Legal Business Name): KRISTEEN ELIZABETH KAGAL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEEN ELIZABETH GRMELA MPAS, PA-C

II. Dates (important events)

Enumeration Date: 10/09/2008
Last Update Date: 06/27/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4716 ALLIANCE BLVD STE 210
PLANO TX
75093-5554
US

IV. Provider business mailing address

9456 STATE HIGHWAY 121 STE 100
FRISCO TX
75035-6067
US

V. Phone/Fax

Practice location:
  • Phone: 469-800-4770
  • Fax:
Mailing address:
  • Phone: 214-817-4225
  • Fax: 972-674-2788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: