Mary Gotcher

Individual provider Active NPI General Practice Registered Nurse · Elkhart, TX

NPI 1497006282 · NPPES record last updated Sep 20, 2012

Key facts

NPI
1497006282
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Registered Nurse 163WG0000X
License
241946 (TX)
Practice address
313 W Parker St
Elkhart, TX 75839-7612
Phone
(903) 764-5686
NPI assigned
Sep 20, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 241946 TX Yes

Addresses

Primary practice location

313 W Parker St
Elkhart, TX 75839-7612

Mailing address

PO Box 4550
Palestine, TX 75802-4550
Phone (903) 731-4555

Other providers in Elkhart, TX

All providers in Elkhart, TX · General Practice Registered Nurse in Texas

Sources for this page

Verify at the official NPI Registry.