Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 109076 | TX |
NPI | 1255690343 |
---|---|
Provider Name | Mr. Troy Matthew Gayler |
First Address | Cleburne, TX 76033-3216 |
Second Address | Cleburne, TX 76033-7030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2012 |
Last Update Date | 09/05/2012 |