Provider Demographics
NPI:1346562410
Name:GERARD W BOYNTON M.D. PA PSC
Entity Type:Organization
Organization Name:GERARD W BOYNTON M.D. PA PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:BOYNTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-452-2480
Mailing Address - Street 1:3301 S ALAMEDA ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1882
Mailing Address - Country:US
Mailing Address - Phone:361-452-2480
Mailing Address - Fax:361-452-2484
Practice Address - Street 1:3301 S ALAMEDA ST
Practice Address - Street 2:SUITE 212
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1882
Practice Address - Country:US
Practice Address - Phone:361-452-2480
Practice Address - Fax:361-452-2484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty