Provider Demographics
NPI:1538140470
Name:PATRICIA A. GUNTER, M.D.
Entity Type:Organization
Organization Name:PATRICIA A. GUNTER, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:GUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-474-1043
Mailing Address - Street 1:900 E 30TH ST
Mailing Address - Street 2:#303
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3326
Mailing Address - Country:US
Mailing Address - Phone:512-474-1043
Mailing Address - Fax:512-474-8100
Practice Address - Street 1:900 E 30TH ST
Practice Address - Street 2:#303
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3326
Practice Address - Country:US
Practice Address - Phone:512-474-1043
Practice Address - Fax:512-474-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1743437Medicaid
TX00373VMedicare ID - Type UnspecifiedMEDICARE