Provider Demographics
NPI:1710279195
Name:BEYL, GAYLE HOLLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:HOLLEY
Last Name:BEYL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GAYLE
Other - Middle Name:ANDREA
Other - Last Name:HOLLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3087
Mailing Address - Street 2:SUITE 230
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-3087
Mailing Address - Country:US
Mailing Address - Phone:225-686-4982
Mailing Address - Fax:225-686-4961
Practice Address - Street 1:17199 SPRING RANCH RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LIVINGSTON
Practice Address - State:LA
Practice Address - Zip Code:70754-2900
Practice Address - Country:US
Practice Address - Phone:225-686-4982
Practice Address - Fax:225-686-4961
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206562207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA356160YJXFMedicare PIN