Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | G8126 | TX |
N | 2084N0402X | Child Neurologist | G8126 | TX |
NPI | 1033189022 |
---|---|
Provider Name | Charles T Gay |
First Address | San Antonio, TX 78229-3713 |
Second Address | San Antonio, TX 78229-3713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 26/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100825910A | (05) | OK |
129615407 | (05) | TX |
129615408 | (05) | TX |
8AJ972 | BCBS OF TEXAS (01) | TX |