Provider Demographics
NPI:1568118644
Name:GANTER, ALLISON (PA-C)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:GANTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:8210 WALNUT HILL LN STE 310
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4419
Mailing Address - Country:US
Mailing Address - Phone:214-750-1207
Mailing Address - Fax:
Practice Address - Street 1:5900 ALTAMESA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-5473
Practice Address - Country:US
Practice Address - Phone:817-854-9969
Practice Address - Fax:833-604-0854
Is Sole Proprietor?:No
Enumeration Date:2022-02-26
Last Update Date:2022-03-31
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant