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General NPI Number Information
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NPI Number | 1518269133
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Entity Type | Organization
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Legal Business Name | GARY B. WATTS, M.D, P.A.
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Dates
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Enumeration Date | 12/02/2010
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Last Update Date | 12/02/2010
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Provider Practice Location Address
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Address Line | 2925 COUNTRY CLUB RD SUITE 102
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City | DENTON
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State | TX
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Zip | 76210-8603
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Country | US
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Telephone | 940-382-1120
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Fax | 940-383-1499
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Provider Business Mailing Address
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Address Line | 2925 COUNTRY CLUB RD SUITE 102
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City | DENTON
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State | TX
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Zip | 76210-8603
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Country | US
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Telephone | 940-382-1120
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Fax | 940-383-1499
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Authorized Official
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Title or Position | PHYSICIAN OWNER/PRESIDENT
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Name | DR. GARY B. WATTS
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Credential |
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Telephone | 940-382-1120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | H6692
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License Number State | TX
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