1538140470 NPI number — PATRICIA A. GUNTER, M.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538140470 NPI number — PATRICIA A. GUNTER, M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATRICIA A. GUNTER, M.D.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538140470
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
900 E 30TH ST
Provider Second Line Business Mailing Address:
#303
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78705-3326
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-474-1043
Provider Business Mailing Address Fax Number:
512-474-8100

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 E 30TH ST
Provider Second Line Business Practice Location Address:
#303
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78705-3326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-474-1043
Provider Business Practice Location Address Fax Number:
512-474-8100
Provider Enumeration Date:
11/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GUNTER
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
ANNE
Authorized Official Title or Position:
PRESIDENT/PHYSICIAN
Authorized Official Telephone Number:
512-474-1043

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1743437 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com