Provider Demographics
NPI:1467740753
Name:PLAKIAS, GARY G (ATP)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:G
Last Name:PLAKIAS
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1908
Mailing Address - Country:US
Mailing Address - Phone:512-458-4589
Mailing Address - Fax:512-454-9521
Practice Address - Street 1:5400 N LAMAR BLVD
Practice Address - Street 2:206B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751
Practice Address - Country:US
Practice Address - Phone:512-275-9848
Practice Address - Fax:512-206-0955
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other