Provider Demographics
NPI:1942428388
Name:GONSER, GAYLENE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:GAYLENE
Middle Name:MARIE
Last Name:GONSER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 864985
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75086-4985
Mailing Address - Country:US
Mailing Address - Phone:214-505-9500
Mailing Address - Fax:
Practice Address - Street 1:4490 ELDORADO PKWY APT 2124
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-3890
Practice Address - Country:US
Practice Address - Phone:214-505-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4959111N00000X
IN08002207A111N00000X
MI2301005613111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor