Provider Demographics
NPI:1932356094
Name:WUCHER, GAY R (MA, CCC-A)
Entity Type:Individual
Prefix:
First Name:GAY
Middle Name:R
Last Name:WUCHER
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 MEDICAL PKWY
Mailing Address - Street 2:SUITE 320
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1019
Mailing Address - Country:US
Mailing Address - Phone:512-454-0392
Mailing Address - Fax:512-454-6019
Practice Address - Street 1:3705 MEDICAL PKWY
Practice Address - Street 2:SUITE 320
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1019
Practice Address - Country:US
Practice Address - Phone:512-454-0392
Practice Address - Fax:512-454-6019
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50649231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L9800Medicare PIN