Lavalais, Gwendolyn L

Lavalais, Gwendolyn L is an sole proprietor health care provider with primary practice located at 2450 N Major Dr , Beaumont TX 77713-9575. She recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Oncology, which is considered as her primary health care specialty. Lavalais, Gwendolyn L can be contacted via phone (409) 981-1800.

Contact Information

Primary practice address
2450 N Major Dr Beaumont TX 77713-9575
Fax: (409) 981-1890
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X M0468 Texas

Profile Details

NPI number 1396729711
LBN Legal business name Lavalais, Gwendolyn L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2005
Last updated Aug 25th, 2022 - about 2 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 1396729711 NPPES
Texas MEDICAID 176502601

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