Individual
JONATHON B GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 QUAIL CREEK DR, AMARILLO, TX 79124
(806) 353-6400
Mailing address
705 QUAIL CREEK DR, AMARILLO, TX 79124
(806) 353-6400
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
L3653
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128496101
SOUTHWEST LIFE & HEALTH
TX
05
—
151644501
—
TX
05
—
200004050A
—
OK
05
—
22454772
—
NM
01
—
88392S
BCBS
TX
01
—
P00045563
MEDICARE RAILROAD
TX
Enumeration date
08/21/2006
Last updated
11/07/2024
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