Provider Demographics
NPI:1013894252
Name:GATEWOOD, TONI
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:GATEWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8816 HORNADAY CIR S APT 304
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76120-3911
Mailing Address - Country:US
Mailing Address - Phone:682-206-6592
Mailing Address - Fax:312-264-0258
Practice Address - Street 1:1901 E ARKANSAS LN STE 102D
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-6800
Practice Address - Country:US
Practice Address - Phone:844-587-7372
Practice Address - Fax:312-264-0258
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service