Provider Demographics
NPI:1902968167
Name:GAMEZ, AGRIPINA PENNY (OD)
Entity Type:Individual
Prefix:DR
First Name:AGRIPINA
Middle Name:PENNY
Last Name:GAMEZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 EVERGREEN TRL
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-3751
Mailing Address - Country:US
Mailing Address - Phone:469-272-0099
Mailing Address - Fax:
Practice Address - Street 1:739 N HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2142
Practice Address - Country:US
Practice Address - Phone:972-291-2288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5831TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist