Provider Demographics
NPI:1770736886
Name:STAGNER, GAYLON FLOYD (RPSGT)
Entity type:Individual
Prefix:MR
First Name:GAYLON
Middle Name:FLOYD
Last Name:STAGNER
Suffix:
Gender:M
Credentials:RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22453 N FM 487
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TX
Mailing Address - Zip Code:76511
Mailing Address - Country:US
Mailing Address - Phone:254-527-4672
Mailing Address - Fax:
Practice Address - Street 1:1901 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-7451
Practice Address - Country:US
Practice Address - Phone:254-743-0392
Practice Address - Fax:254-743-0393
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246Z00000X246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other