1932102316 NPI number — DR. LAURA K GILBEY M.D.

Table of content: DR. LAURA K GILBEY M.D. (NPI 1932102316)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932102316 NPI number — DR. LAURA K GILBEY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GILBEY
Provider First Name:
LAURA
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WHITE
Provider Other First Name:
LAURA
Provider Other Middle Name:
K
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1932102316
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/24/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3600 W PARMER LN
Provider Second Line Business Mailing Address:
STE 106
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78727-4107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-977-0123
Provider Business Mailing Address Fax Number:
512-977-0126

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3600 W PARMER LN
Provider Second Line Business Practice Location Address:
STE 106
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78727-4107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-977-0123
Provider Business Practice Location Address Fax Number:
512-977-0126
Provider Enumeration Date:
05/31/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0200X , with the licence number:  K0570 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RP1001X , with the licence number: K0570 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1456295-04 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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