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General NPI Number Information
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NPI Number | 1033189022
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Entity Type | Individual
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Provider Name | CHARLES T GAY M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 09/26/2011
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Provider Practice Location Address
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Address Line | 4499 MEDICAL DR STE 396
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3713
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Country | US
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Telephone | 210-614-3737
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Fax | 210-614-3147
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Provider Business Mailing Address
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Address Line | 4499 MEDICAL DR STE 396
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3713
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Country | US
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Telephone | 210-614-3737
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Fax | 210-614-3147
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | G8126
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | G8126
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License Number State | TX
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