Healthcare Provider Details

I. General information

NPI: 1710039037
Provider Name (Legal Business Name): DONALD EDWARD GWARTNEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 S PADRE ISLAND DR SUITE 18
CORPUS CHRISTI TX
78412-4055
US

IV. Provider business mailing address

6500 S PADRE ISLAND DR SUITE 18
CORPUS CHRISTI TX
78412-4055
US

V. Phone/Fax

Practice location:
  • Phone: 361-992-2048
  • Fax: 361-992-2094
Mailing address:
  • Phone: 361-992-2048
  • Fax: 361-992-2094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6998
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: