Provider Demographics
NPI:1730457730
Name:LITTLE, GREGORY SCOTT
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:SCOTT
Last Name:LITTLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 W PECAN ST STE 8
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2607
Mailing Address - Country:US
Mailing Address - Phone:512-251-5977
Mailing Address - Fax:512-251-6017
Practice Address - Street 1:1101 W PECAN ST STE 8
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2607
Practice Address - Country:US
Practice Address - Phone:512-251-5977
Practice Address - Fax:512-251-6017
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other