Provider Demographics
NPI:1174509475
Name:GAYLE, KAREN LEAH (LPT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LEAH
Last Name:GAYLE
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 W WHEELER AVE
Mailing Address - Street 2:STE A
Mailing Address - City:ARANSAS PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78336-4557
Mailing Address - Country:US
Mailing Address - Phone:361-758-7384
Mailing Address - Fax:361-758-3546
Practice Address - Street 1:1560 W WHEELER AVE
Practice Address - Street 2:STE A
Practice Address - City:ARANSAS PASS
Practice Address - State:TX
Practice Address - Zip Code:78336-4557
Practice Address - Country:US
Practice Address - Phone:361-758-7384
Practice Address - Fax:361-758-3546
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1009694225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX650150Medicare ID - Type Unspecified