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NPI Code Detail

MEDICARE: DR. GINA GAGEN

MEDICARE:  DR. GINA  GAGEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor64538TX

General Provider Information

NPI Number : 1891962775
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GINA GAGEN
Provider Business Mailing Address
First Line : 4607 SYLVAN GLEN DR
Second Line :
City : HOUSTON
State : TX
Zip : 77084-3640
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4607 SYLVAN GLEN DR
Second Line :
City : HOUSTON
State : TX
Zip : 77084
Country : US
Telephone Number : 928-444-3333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2008
Last Update Date : 08/31/2018

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Directions to “ DR. GINA GAGEN ” Practice Location

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