Ganzon Clinic PA

Organization Active NPI Family Medicine Physician · Springtown, TX

NPI 1386600948 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1386600948
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
GANZON CLINIC PA
Practice address
499 E Hwy 199
Springtown, TX 76082
Phone
(817) 523-5402
Fax
(817) 523-5422
NPI assigned
Apr 24, 2006
Organization subpart
No

Authorized official

Name
Mauro S Ganzon, MD
Title
President
Phone
(817) 523-5402

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

1821 S FM 51
Decatur, TX 76234
Phone (855) 277-2979

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

499 E Hwy 199
Springtown, TX 76082

Mailing address

PO Box 1039
Springtown, TX 76082
Phone (817) 523-5402

Other identifiers

IdentifierTypeStateIssuer
84LZOtherTXBCBS

Other providers in Springtown, TX

All providers in Springtown, TX · Family Medicine Physician in Texas

Sources for this page

Verify at the official NPI Registry.