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1417355819
SAMANTHA KAYE ETHRIDGE
WACO, TX
NPI
1417355819
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Former Name
SAMANTHA KAYE GAMMEL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: TX PA09447)
Enumeration Date
2014-12-17
Last Update Date
2016-11-03
Business Address
SAMANTHA KAYE ETHRIDGE PA
1800 GURLEY LN
WACO, TX 76706-4025
Phone number: 254-313-6000
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Mailing Address
SAMANTHA KAYE ETHRIDGE PA
1600 PROVIDENCE DR
WACO, TX 76707-2261
Phone number: 254-313-4200
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