GREGORY SCOTT WALLIS

NACOGDOCHES, TX
NPI1376698290
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: TX  630401)
Enumeration Date2007-01-23
Last Update Date2014-11-04
Business Address
Mr. GREGORY SCOTT WALLIS CRNA
1204 N MOUND ST
NACOGDOCHES, TX 75961-4027
Phone number: 936-568-8444
Mailing Address
Mr. GREGORY SCOTT WALLIS CRNA
106 COUNTY ROAD 253
NACOGDOCHES, TX 75965-6980
Phone number: 936-554-7297