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Kirk Gautier is one of 211 physician assistants practicing in Tyler, Texas .
Kirk Gautier practices with Oliver Street 5.01(A) Inc.
Registry record (NPPES)
NPI
1821027798
Type
Type 1 · Individual
Primary taxonomy
Physician Assistant · 363A00000X
Address on file
805 S Palestine St Athens, TX 75751-3427 (903) 534-6200
Enumerated
Jul 2, 2006
Record last updated
Aug 4, 2017
License states listed
TX
Medicare (CMS)
Enrollment
Medicare-enrolled in TXPhysician Assistant
Revalidation due
No date set by CMS
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Part D prescribing
Procedure volumes by CPT code
Group affiliations and colleagues
Full enrollment history
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Practice locations
1367 Dominion Plz
Tyler , TX 75703
(903) 534-6200
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Updated August 2026. Practice locations and specialty come from the CMS Doctors and Clinicians file, the registry record from NPPES, and enrollment from CMS Medicare enrollment files. NPI records are corrected at the source, through NPPES.
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