Gaddis, Justin

Gaddis, Justin is an individual health care provider with primary practice located at 800 E Dawson St , Tyler TX 75701-2036. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Gaddis, Justin can be contacted via phone (903) 593-8441.

Contact Information

Primary practice address
800 E Dawson St Tyler TX 75701-2036
Phone: (903) 593-8441
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 151866 Texas

Profile Details

NPI number 1992042246
LBN Legal business name Gaddis, Justin
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 7th, 2013
Last updated Oct 13th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992042246 NPPES
Texas Other 8305UE BCBS
Texas Other 75-0818167-015 BCBS
Texas Other P01200603 BCBS

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