Individual
DR. GWENDOLYN L LAVALAIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2450 N MAJOR DR, BEAUMONT, TX 77713-9575
(409) 981-1800
(409) 981-1890
Mailing address
2450 N MAJOR DR, BEAUMONT, TX 77713-9575
(409) 981-1800
(409) 981-1890
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
M0468
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176502601
—
TX
Enumeration date
11/30/2005
Last updated
08/25/2022
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