Healthcare Provider Details
I. General information
NPI: 1508182668
Provider Name (Legal Business Name): GAYLE YVONNE AYERS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/14/2010
Last Update Date: 12/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1301 W 38TH ST SUITE 700
AUSTIN TX
78705-1000
US
IV. Provider business mailing address
1301 W 38TH ST SUITE 700
AUSTIN TX
78705-1000
US
V. Phone/Fax
- Phone: 512-324-3380
- Fax: 512-324-3379
- Phone: 512-324-3380
- Fax: 512-324-3379
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 53260 |
| License Number State | CT |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | P6133 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: