Provider Demographics
NPI:1841776945
Name:ANGER, GARY WILLIAM (RN)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:WILLIAM
Last Name:ANGER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4099 MCEWEN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75244-5050
Mailing Address - Country:US
Mailing Address - Phone:972-754-1281
Mailing Address - Fax:
Practice Address - Street 1:4099 MCEWEN RD STE 200
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75244-5050
Practice Address - Country:US
Practice Address - Phone:972-754-1281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX789487163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice