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Contact Information

4500 GULFWAY MEDICAL MANAGEMENT PA
4500 GULFWAY DRIVE
PORT ARTHUR, TX77642
 Phone: 409-982-5110
 Fax: 409-982-8196
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for 4500 GULFWAY MEDICAL MANAGEMENT PA · (Female)

NPI Number 1326100439
Status Active
Credentials
Entity Individual
Enumeration date 12/14/2006
Last updated 10/29/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • TX License # D5588
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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