Gwendolyn Champion, LSA is a
Physician Assistant - Surgical based in Fresno, Texas. Gwendolyn Champion is licensed to practice in * (Not Available) (license number SA00547) and her current practice location is
4026 E Teal Estates Cir, Fresno, Texas. She can be reached at her office (for appointments etc.) via phone at
(510) 984-8610.
NPI number for Gwendolyn Champion is 1407241300 and her current mailing address is 4026 E Teal Estates Cir, Fresno, Texas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1407241300.
Provider's Profile
Full Name | Gwendolyn Champion |
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Gender | Female |
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Speciality | Physician Assistant - Surgical |
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Location | 4026 E Teal Estates Cir, Fresno, Texas |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1407241300
- Provider Enumeration Date: 03/30/2015
- Last Update Date: 04/30/2020
Medical Identifiers
Medical identifiers for Gwendolyn Champion such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1407241300 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363AS0400X | Physician Assistant - Surgical | SA00547 (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gwendolyn Champion is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Gwendolyn Champion, LSA 4026 E Teal Estates Cir, Fresno, TX 77545-8851 Ph: (510) 984-8610 | Gwendolyn Champion, LSA 4026 E Teal Estates Cir, Fresno, TX 77545 Ph: (510) 984-8610 |
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