Provider Demographics
NPI:1285738724
Name:GASKIN, DAVID (CRNA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GASKIN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10592 COUNTY ROAD 175
Mailing Address - Street 2:
Mailing Address - City:IOLA
Mailing Address - State:TX
Mailing Address - Zip Code:77861-3617
Mailing Address - Country:US
Mailing Address - Phone:979-229-9188
Mailing Address - Fax:979-703-1426
Practice Address - Street 1:3201 UNIVERSITY DR E STE 370
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3485
Practice Address - Country:US
Practice Address - Phone:979-703-1426
Practice Address - Fax:979-709-1427
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2024-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX600960163W00000X
TX049819367500000X
TXAP109201163WP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0000XNursing Service ProvidersRegistered NursePain Management
No163W00000XNursing Service ProvidersRegistered Nurse
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0026486-01Medicaid
TX81930HMedicare PIN
TX430044750Medicare PIN