1700011590 NPI number — LAUREN GAYLE ASH M.D.

Table of content: LAUREN GAYLE ASH M.D. (NPI 1700011590)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700011590 NPI number — LAUREN GAYLE ASH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ASH
Provider First Name:
LAUREN
Provider Middle Name:
GAYLE
Provider Name Prefix Text:
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:
SOWREY
Provider Other First Name:
LAUREN
Provider Other Middle Name:
GAYLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1700011590
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5920 W WILLIAM CANNON DR, BUILDING 7
Provider Second Line Business Mailing Address:
BLDG 7 STE 100
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78749-1902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-615-3562
Provider Business Mailing Address Fax Number:
888-972-4864

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5920 W WILLIAM CANNON DR
Provider Second Line Business Practice Location Address:
BUILDING 7, SUITE 100
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78749-1902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-615-3562
Provider Business Practice Location Address Fax Number:
888-972-4864
Provider Enumeration Date:
05/21/2009

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: 208600000X , with the licence number:  BP1-0035437 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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