Provider Demographics
NPI:1598861494
Name:GAYLE V VOTH MD PA
Entity Type:Organization
Organization Name:GAYLE V VOTH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:V
Authorized Official - Last Name:VOTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-783-0947
Mailing Address - Street 1:399 WEST CAMPBELL
Mailing Address - Street 2:SUITE 402
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3636
Mailing Address - Country:US
Mailing Address - Phone:972-783-0947
Mailing Address - Fax:972-783-0948
Practice Address - Street 1:399 WEST CAMPBELL
Practice Address - Street 2:SUITE 402
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3636
Practice Address - Country:US
Practice Address - Phone:972-783-0947
Practice Address - Fax:972-783-0948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7309207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031955001Medicaid
TX00AT07OtherBCBS TX
TX4019630OtherAETNA
B27370Medicare UPIN
TX00AT07Medicare PIN
TX4019630OtherAETNA