Basic Information
| Provider Information | |||||||||
| NPI: | 1235435116 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUON | ||||||||
| FirstName: | GINA | ||||||||
| MiddleName: | GABRIELLA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MPAS, PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17101 PRESTON RD | ||||||||
| Address2: | STE 200 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752481374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4693037000 | ||||||||
| FaxNumber: | 4694562897 | ||||||||
| Practice Location | |||||||||
| Address1: | 7601 PRESTON RD | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750243214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4693037000 | ||||||||
| FaxNumber: | 4694562897 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2011 | ||||||||
| LastUpdateDate: | 06/17/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA06603 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.