Provider Demographics
NPI:1992731079
Name:HAWKINS, GARY LINDLEY II (PA-C)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:LINDLEY
Last Name:HAWKINS
Suffix:II
Gender:M
Credentials:PA-C
Other - Prefix:MR
Other - First Name:GARY
Other - Middle Name:LINDLEY
Other - Last Name:HAWKINS
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:505 SPRING CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76087-7350
Mailing Address - Country:US
Mailing Address - Phone:682-351-7765
Mailing Address - Fax:
Practice Address - Street 1:5700 EAST 1-20 SERVICE ROAD SOUTH
Practice Address - Street 2:SUITE 100
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-5115
Practice Address - Country:US
Practice Address - Phone:817-489-7300
Practice Address - Fax:817-489-7301
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03518363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP74464Medicare UPIN