Provider Demographics
NPI:1619969730
Name:GAYLE, ROSALYN ANN (MD)
Entity Type:Individual
Prefix:
First Name:ROSALYN
Middle Name:ANN
Last Name:GAYLE
Suffix:
Gender:F
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 1453
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77522-1453
Mailing Address - Country:US
Mailing Address - Phone:281-837-2100
Mailing Address - Fax:281-837-8878
Practice Address - Street 1:1674 W BAKER RD STE A
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2285
Practice Address - Country:US
Practice Address - Phone:281-837-2100
Practice Address - Fax:281-837-8878
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6232207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX94179OtherAMERIGROUP
TX030199601Medicaid
TX0063EWOtherB/C B/S
TX94179OtherAMERIGROUP
TX030199601Medicaid