Provider Demographics
NPI:1598490138
Name:GASTON, LINDA JOYCE
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:JOYCE
Last Name:GASTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2213 W. LINCOLN ST.
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552
Mailing Address - Country:US
Mailing Address - Phone:956-495-0402
Mailing Address - Fax:
Practice Address - Street 1:2213 W. LINCOLN ST.
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552
Practice Address - Country:US
Practice Address - Phone:956-495-0402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT117952225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist