Provider Demographics
NPI:1780246132
Name:GAPUZ, KRISTINE TAN (MD)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:TAN
Last Name:GAPUZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1600 WATERS RIDGE DR STE A
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-6039
Mailing Address - Country:US
Mailing Address - Phone:972-219-0558
Mailing Address - Fax:
Practice Address - Street 1:6331 BOULEVARD 26 STE 220
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-1592
Practice Address - Country:US
Practice Address - Phone:817-628-0284
Practice Address - Fax:817-628-0288
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-07
Last Update Date:2024-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXV0739207RN0300X, 207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology