Provider Demographics
NPI:1285627158
Name:SEAY, GAYLON B (MD)
Entity Type:Individual
Prefix:DR
First Name:GAYLON
Middle Name:B
Last Name:SEAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 94088
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79493-4088
Mailing Address - Country:US
Mailing Address - Phone:806-795-9559
Mailing Address - Fax:806-791-5253
Practice Address - Street 1:5009 UNIVERSITY AVE
Practice Address - Street 2:SUITE G
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-4431
Practice Address - Country:US
Practice Address - Phone:806-795-9559
Practice Address - Fax:806-791-5253
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8895174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094768101Medicaid
TX094768101Medicaid
TX891362Medicare PIN