Provider Demographics
NPI:1134568751
Name:LAY, ALICIA D'ANN (MD)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:D'ANN
Last Name:LAY
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 1:1419 DIAN ST APT D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-3758
Mailing Address - Country:US
Mailing Address - Phone:817-991-8889
Mailing Address - Fax:
Practice Address - Street 1:1419 DIAN ST APT D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-3758
Practice Address - Country:US
Practice Address - Phone:817-991-8889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR8594208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR8594OtherTEXAS MEDICAL BOARD