NPI 1316929888

Gail Tyria Houston, PAC

Practitioner Medical Physician Assistant Fort Leavenworth, KS

Practice location

Address: 210 Grant Ave Room 1809, Fort Leavenworth, KS 66027-1231
Phone: (913) 758-3791
Mailing address: 2412 Mountain Rd, Joppa, MD 21085-2338

Registered specialties

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence C100031 (MD)

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Registry record

NPI: 1316929888
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Nov 2005
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.