Munn, Gordon Lance
Munn, Gordon Lance is an sole proprietor health care provider with primary practice located at 675 Town Square Blvd Suite 200, Building 1A, Garland TX 75040. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Munn, Gordon Lance can be contacted via phone (214) 804-9262.Contact Information
Primary practice address
675 Town Square Blvd Suite 200, Building 1A
Garland TX 75040
Phone: (214) 804-9262
Fax: (972) 495-1863
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 22687 | Texas |
Profile Details
| NPI number | 1417957192 |
|---|---|
| LBN Legal business name | Munn, Gordon Lance |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 26th, 2005 |
| Last updated | Jun 24th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417957192 | NPPES |
| Texas | MEDICAID | 064284501 |
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