Provider Demographics
NPI:1942395900
Name:REACH, GAYLA M (NP)
Entity type:Individual
Prefix:
First Name:GAYLA
Middle Name:M
Last Name:REACH
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:503 MAIN ST
Mailing Address - Street 2:STE C
Mailing Address - City:LAKE DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75065-2878
Mailing Address - Country:US
Mailing Address - Phone:940-382-5230
Mailing Address - Fax:
Practice Address - Street 1:1200 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-2376
Practice Address - Country:US
Practice Address - Phone:817-429-8300
Practice Address - Fax:817-429-6167
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP104113363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR75043Medicare UPIN