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General NPI Number Information
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NPI Number | 1508196346
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Entity Type | Individual
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Provider Name | WENDY MCGINTY-GAMBLE PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/29/2009
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Last Update Date | 10/14/2016
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Provider Practice Location Address
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Address Line | 12201 RENFERT WAY STE 225
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City | AUSTIN
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State | TX
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Zip | 78758-5369
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Country | US
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Telephone | 512-339-6626
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Fax | 512-425-3809
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Provider Business Mailing Address
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Address Line | 12201 RENFERT WAY STE 225
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City | AUSTIN
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State | TX
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Zip | 78758-5369
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Country | US
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Telephone | 512-339-6626
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Fax | 512-425-3809
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA00021
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License Number State | TX
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