Shaundra Gontina

Individual provider Active NPI Adult Companion · La Marque, TX

NPI 1174200570 · NPPES record last updated Jun 28, 2023

Key facts

NPI
1174200570
Entity type
Individual (NPI type 1)
Primary specialty
Adult Companion 372600000X
Practice address
236 Muriel St
La Marque, TX 77568-6153
Phone
(409) 454-1138
NPI assigned
Jun 28, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Companion
Group: 193400000X SINGLE SPECIALTY GROUP
372600000X Yes

Addresses

Primary practice location

236 Muriel St
La Marque, TX 77568-6153

Mailing address

236 Muriel St
La Marque, TX 77568-6153
Phone (409) 454-1138

Other providers in La Marque, TX

All providers in La Marque, TX · Adult Companion in Texas

Sources for this page

Verify at the official NPI Registry.