Doctor Name: | DAVID MCMURRAY GANCERES |
NPI Number: | 1245685460 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NP |
License Number: | AP130623 |
Business Practice Address: | 3010 E Business 190 Ste 254 Copperas Cove, TX - 765222517 |
Business Phone Number: | 2545184711 |
Business Fax Number: | 2545184715 |
Mailing Address: | Po Box 938, KILLEEN |
State: | TX |
Postal Code: | 765400938 |
Phone Number: | 2542459045 |
Fax Number: | 2542459284 |
NPI Enumeration Date: | 04/25/2016 |
NPI Last Update Date: | 04/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP130623 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |