JOEL E. GANGROSS (NPI# 1407052103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407052103 |
| Entity Type | Individual |
| Full Name | JOEL E. GANGROSS |
| Credential | LAT |
| Practice Address |
3414 Golden Rd Tyler TX 75701-8336 |
| Mailing Address |
12002 County Road 4401 Larue TX 75770-6101 |
| Practice Telephone | 9039397500 |
| Practice Fax Number | 9035971245 |
| Mailing Telephone | 9038300604 |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | AT2040 | TX | Other Service Providers |
| Street Address |
3414 GOLDEN RD |
| City | TYLER |
| State | TX |
| Zip Code | 75701-8336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487640173 | James Robert Harris | Orthopaedic Surgery | 3414 Golden Rd, Tyler, TX 75701-8336 | 2005-09-27 |
| 1104433739 | Ortholonestar, Pllc | Orthopaedic Surgery | 3414 Golden Rd, Tyler, TX 75701-8336 | 2020-09-28 |
| 1912528498 | Brooke Nicole Mcdaniel | Occupational Therapy Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2020-05-06 |
| 1912526153 | Iana G Harris | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2020-04-08 |
| 1104450832 | Lindsey Michelle Markel | Nurse Practitioner | 3414 Golden Rd, Tyler, TX 75701-8336 | 2020-03-03 |
| 1568009058 | East Texas First Surgical Support Pllc | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2019-12-04 |
| 1770144701 | Olsv3 Pllc | Orthopaedic Surgery | 3414 Golden Rd, Tyler, TX 75701-8336 | 2019-06-20 |
| 1740840651 | Samantha Anderson Ray | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2019-06-13 |
| 1326540097 | Jennifer Marie Mckelva | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2018-03-08 |
| 1730601790 | Justin Alan Williams | Nurse Practitioner | 3414 Golden Rd, Tyler, TX 75701-8336 | 2017-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144572512 | Parent Services Center, Inc. | Specialist | 4411 Old Bullard Rd Ste 602, Tyler, TX 75703-1215 | 2012-10-10 |
| 1093032880 | Misty M Bridges | Specialist | 106 E Heritage Dr Ste 5e, Tyler, TX 75703-5112 | 2010-05-03 |
| 1972820611 | Leah F Woodruff | Specialist | 201 Winchester Dr, Tyler, TX 75701-8847 | 2010-04-20 |
| 1457587248 | Marissa Borromeo | Specialist | 4914 Inverness Dr, Tyler, TX 75703-2604 | 2009-06-07 |
| 1265613889 | Appletree Pediatrics, P.a. | Specialist | 1306 Doctors Dr, Tyler, TX 75701-2262 | 2007-11-26 |
| 1093803116 | Robert L. Boyne, M.d., P.a. | Specialist | 700 Olympic Plaza Cir Ste 912, Tyler, TX 75701-1955 | 2006-10-11 |
| 1760578835 | Jeffrey P. Smith | Specialist | 4801 Troup Hwy S, Suite 301, Tyler, TX 75703 | 2006-10-05 |
| 1952409377 | Rosenfield, Md. Pa | Specialist | 1305 Dr Drive, Tyler, TX 75701-3343 | 2006-09-20 |
| 1275571861 | Joseph Lynn Prud'homme Sr. | Specialist | 1015 E Idel St, Tyler, TX 75701-2025 | 2006-06-03 |
| 1225023070 | Adagio Dermatology and Aesthetics, P.a. | Specialist | 455 Rice Road, Ste. 104, Tyler, TX 75703-3604 | 2005-09-19 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.