Provider Demographics
NPI:1679631451
Name:GONYEAU, PETER T (DC)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:T
Last Name:GONYEAU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 LONG PRAIRIE ROAD
Mailing Address - Street 2:SUITE 107-845
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022
Mailing Address - Country:US
Mailing Address - Phone:972-899-8002
Mailing Address - Fax:972-899-8003
Practice Address - Street 1:2601 SAGEBRUSH DRIVE
Practice Address - Street 2:SUITE 104
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028
Practice Address - Country:US
Practice Address - Phone:972-899-8002
Practice Address - Fax:972-899-8003
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11117111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAGOY45634Medicare ID - Type Unspecified
TXG45634Medicare UPIN