Gonter, Maynard Shawn

Gonter, Maynard Shawn is an individual health care provider with primary practice located at 800 E Dawson St , Tyler TX 75701-2036. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Gonter, Maynard Shawn can be contacted via phone (903) 567-4841.

Contact Information

Primary practice address
800 E Dawson St Tyler TX 75701-2036
Phone: (903) 567-4841
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PAO1417 Texas

Profile Details

NPI number 1396737391
LBN Legal business name Gonter, Maynard Shawn
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2005
Last updated Apr 8th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396737391 NPPES
Texas Other P01608450 RAIL ROAD MEDICARE
Texas MEDICAID 355131901 RAIL ROAD MEDICARE

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