Provider Demographics
NPI:1003876855
Name:ELKINS, GARY R (PHD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:R
Last Name:ELKINS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2027 S 61ST ST
Mailing Address - Street 2:SUITE 121
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-6867
Mailing Address - Country:US
Mailing Address - Phone:254-778-6922
Mailing Address - Fax:254-778-4332
Practice Address - Street 1:2027 S 61ST ST
Practice Address - Street 2:SUITE 121
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-6867
Practice Address - Country:US
Practice Address - Phone:254-778-6922
Practice Address - Fax:254-778-4332
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22520103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0041NUOtherBCBS OF TEXAS
1003876855OtherAETNA
1003876855OtherMAGELLAN
TX1003876855OtherSCOTT AND WHITE HEALTH PL
TX040065701Medicaid
1003876855OtherMAGELLAN
TX040065701Medicaid
TX1003876855OtherSCOTT AND WHITE HEALTH PL