Provider Demographics
NPI:1598997298
Name:HORNER, JOHN GASTON (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:GASTON
Last Name:HORNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 W DALLAS ST
Mailing Address - Street 2:
Mailing Address - City:LLANO
Mailing Address - State:TX
Mailing Address - Zip Code:78643-1649
Mailing Address - Country:US
Mailing Address - Phone:325-216-9072
Mailing Address - Fax:325-399-9064
Practice Address - Street 1:102 W DALLAS ST
Practice Address - Street 2:
Practice Address - City:LLANO
Practice Address - State:TX
Practice Address - Zip Code:78643-1649
Practice Address - Country:US
Practice Address - Phone:325-216-9072
Practice Address - Fax:325-399-9064
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2459207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine