Provider Demographics
NPI:1912901356
Name:GAMEZ, MARCIA K (CNS)
Entity type:Individual
Prefix:MISS
First Name:MARCIA
Middle Name:K
Last Name:GAMEZ
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 N CENTRAL EXPY STE 500
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0805
Mailing Address - Country:US
Mailing Address - Phone:214-220-2468
Mailing Address - Fax:214-720-1982
Practice Address - Street 1:9301 N CENTRAL EXPY STE 500
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0805
Practice Address - Country:US
Practice Address - Phone:214-220-2468
Practice Address - Fax:214-720-1982
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX594694364SM0705X
TXAP113561364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX611439300OtherUS DEPT OF LABOR
TX594694OtherSTATE LICENSE
TX170864602Medicaid
TX0038KEOtherBCBS
TXP00281745OtherRAILROAD MEDICARE
TX612091Medicare ID - Type UnspecifiedMCR
TX170864602Medicaid