Clayton A Gautreaux D.D.S
LBN: Clayton A Gautreaux D.D.S
Clayton A Gautreaux D.D.S is an health care organization with primary practice located at 302 N 3Rd St , Mabank TX 75147-8611. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry. Dental Providers / General Practice is the primary health care specialty.
Clayton A Gautreaux D.D.S can be contacted via phone (903) 887-4405, or through Passons, Gena D via phone (903) 887-4405.
Contact Information
Primary practice address
302 N 3Rd St
Mabank TX 75147-8611
Phone: (903) 887-4405
Fax:
Website:
Authorized official contact:
Name: Passons, Gena D Registered Dental Assistant (RDA)
Phone: (903) 887-4405
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 12190 | Texas |
| Dental Providers / General Practice | 1223G0001X | 23280 | Texas |
| Dental Providers / Pediatric Dentistry | 1223P0221X | 14921 | Texas |
Profile Details
| NPI number | 1043549603 |
|---|---|
| LBN Legal business name | Clayton A Gautreaux D.D.S |
| DBA Doing business as | |
| Authorized official | Passons, Gena D Registered Dental Assistant (RDA) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 10th, 2009 |
| Last updated | Dec 10th, 2009 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043549603 | NPPES |
| Texas | MEDICAID | 14921 | |
| Texas | MEDICAID | 12190 | |
| Texas | MEDICAID | 23280 |
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