Healthcare Provider Details

I. General information

NPI: 1356713556
Provider Name (Legal Business Name): GUNTER MEDICAL CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2015
Last Update Date: 04/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 N 8TH ST SUITE 2
GUNTER TX
75058-3586
US

IV. Provider business mailing address

7504 SAN JACINTO PL
PLANO TX
75024-3233
US

V. Phone/Fax

Practice location:
  • Phone: 972-769-7246
  • Fax: 972-769-8811
Mailing address:
  • Phone: 972-769-7246
  • Fax: 972-769-8811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberM1789
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NISHA JAIN
Title or Position: PRESIDENT
Credential: MD
Phone: 972-769-7246