Provider Demographics
NPI:1780403113
Name:GAYNOR, SYLVIA A
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:A
Last Name:GAYNOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11335 SSG SIMS ST
Mailing Address - Street 2:
Mailing Address - City:FORT BLISS
Mailing Address - State:TX
Mailing Address - Zip Code:79918-8033
Mailing Address - Country:US
Mailing Address - Phone:915-742-1321
Mailing Address - Fax:
Practice Address - Street 1:11335 SSG SIMS ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79918-8033
Practice Address - Country:US
Practice Address - Phone:915-742-1333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other