Active NPI
Gary Lee Dunham, PA-C
- Medical Physician Assistant
- San Antonio, TX
National Provider Identifier
1952520793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA00556
- Practice address
- 1933 NE Loop 410
San Antonio, TX 78217-5320 - Phone
- (210) 804-6000
- Fax
- (210) 804-6087
- NPI assigned
- Apr 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 00556 | TX | |
| Medical Physician Assistant | 363AM0700X | PA00556 | TX | Primary |
Addresses
Primary practice location
1933 NE Loop 410
San Antonio, TX 78217-5320
Mailing address
7711 Louis Pasteur Dr, Suite 407
San Antonio, TX 78229
Phone (210) 614-4405
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00556 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292371200000",
"number": "1952520793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7711 LOUIS PASTEUR DR, SUITE 407",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78229",
"telephone_number": "210-614-4405",
"fax_number": "210-614-7892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1933 NE LOOP 410",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782175320",
"telephone_number": "210-804-6000",
"fax_number": "210-804-6087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNHAM",
"first_name": "GARY",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-24",
"last_updated": "2010-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "00556",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA00556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.