Organization
GANTT MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTI M GANTT PA-C (OWNER)
(903) 875-2188
Entity
Organization
Contact information
Practice address
3200 W HIGHWAY 22, CORSICANA, TX 75110-2449
(903) 875-2188
(903) 875-2186
Mailing address
PO BOX 368, CORSICANA, TX 75151-0368
(903) 875-2188
(903) 875-2186
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA07344
TX
Other
Enumeration date
06/03/2013
Last updated
09/25/2015
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