Provider Demographics
NPI:1144425612
Name:NANAGAS, GABRIEL RAYMOND (PA-C)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:RAYMOND
Last Name:NANAGAS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2329 TAMARISK LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-6422
Mailing Address - Country:US
Mailing Address - Phone:972-596-9293
Mailing Address - Fax:
Practice Address - Street 1:3211 PRESTON RD STE 5
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9020
Practice Address - Country:US
Practice Address - Phone:469-213-7996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA01958363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00876586OtherRAILROAD MEDICARE PTAN
TXP00876586OtherRAILROAD MEDICARE PTAN