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General NPI Number Information
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NPI Number | 1528618121
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Entity Type | Individual
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Provider Name | ETHAN DAVID GAGER NP
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Gender | Male
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Dates
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Enumeration Date | 09/16/2019
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 2700 E ELDORADO PKWY
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City | LITTLE ELM
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State | TX
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Zip | 75068-5999
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Country | US
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Telephone | 972-987-0458
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Fax |
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Provider Business Mailing Address
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Address Line | 1432 CREEK SPRINGS DR
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City | ALLEN
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State | TX
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Zip | 75002-0993
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Country | US
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Telephone | 214-385-5920
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Fax |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AP139837
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 907598
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95034313
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License Number State | CA
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