Gantt Medical, PLLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA07344 Issued in TX

Legal business name

GANTT MEDICAL, PLLC

Practice address

3200 W Highway 22
Corsicana, TX 75110-2449

Phone

(903) 875-2188

Fax

(903) 875-2186

NPI assigned

Jun 3, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marti M Gantt, PA-C

Title

Owner

Phone

(903) 875-2188

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1740627512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751510368",
            "telephone_number": "903-875-2188",
            "fax_number": "903-875-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 W HIGHWAY 22",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102449",
            "telephone_number": "903-875-2188",
            "fax_number": "903-875-2186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GANTT MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-03",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "GANTT",
        "authorized_official_first_name": "MARTI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-875-2188",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA07344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Corsicana, TX
• Providers in Corsicana, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.