GANTT MEDICAL PLLC NPI 1740627512

NPI Information

NPI: 1740627512
Provider Name: GANTT MEDICAL, PLLC
Classification: Physician Assistant - 363AM0700X
Entity Type: Organization

Specialization: Medical

Address:
3200 W HIGHWAY 22
CORSICANA, TX
ZIP 75110
Phone: (903) 875-2188
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GANTT MEDICAL, PLLC is a medical physician assistant in Corsicana, TX. GANTT MEDICAL, PLLC NPI is 1740627512. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3200 W HIGHWAY 22
CORSICANA, TX
ZIP 75110-449
Phone: (903) 875-2188
Fax: (903) 875-2186

The provider's authorized official is Marti M Gantt .
The authorized official title is Owner and has the following contact phone number (903) 875-2188.

The enumeration date for this NPI number is 6/3/2013 and was last updated on 9/25/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA07344	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	301868	MEDICARE PIN	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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