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NPI Code Detail

MEDICARE: VONNI C GANT M.D.

MEDICARE: VONNI C GANT M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianP1306TX
2208000000XPediatrics PhysicianMD482542PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194967687
Entity Type Code : Individual
Provider Name (Legal Business Name) : VONNI C GANT M.D.
Provider Business Mailing Address
First Line : 3201 W SANER AVE
Second Line :
City : DALLAS
State : TX
Zip : 75233-1430
Country : US
Telephone Number : 214-331-0567
Fax Number : 214-337-7779
Provider Business Practice Location Address
First Line : 3201 W SANER AVE
Second Line :
City : DALLAS
State : TX
Zip : 75233-1430
Country : US
Telephone Number : 214-331-0567
Fax Number : 214-337-7779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2009
Last Update Date : 05/29/2026

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Directions to “ VONNI C GANT M.D.” Practice Location

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