Healthcare Provider Details

I. General information

NPI: 1457333627
Provider Name (Legal Business Name): ALLYSON GAYLOR PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TEXAS TECH SCHOOL OF PHARMACY 3601 4TH STREET, MS 8162
LUBBOCK TX
79430-0001
US

IV. Provider business mailing address

411 JUNEAU AVE
LUBBOCK TX
79416-4151
US

V. Phone/Fax

Practice location:
  • Phone: 806-743-4200
  • Fax: 806-743-4209
Mailing address:
  • Phone: 806-535-7993
  • Fax: 806-743-4209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number37073
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: