Provider Demographics
NPI:1033275136
Name:LANGSTON, LINDA GAIL (RNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:GAIL
Last Name:LANGSTON
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 TIMOTHY TRL
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-4018
Mailing Address - Country:US
Mailing Address - Phone:972-298-7645
Mailing Address - Fax:
Practice Address - Street 1:2800 E BROAD STREET SUITE 400
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063
Practice Address - Country:US
Practice Address - Phone:817-477-9292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX502406363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP43183Medicare UPIN
TX86N595Medicare ID - Type Unspecified