Provider Demographics
NPI:1104859859
Name:GAY, PAULA C (PHD)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:C
Last Name:GAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 93042
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78709-3042
Mailing Address - Country:US
Mailing Address - Phone:512-323-6211
Mailing Address - Fax:
Practice Address - Street 1:1510 W 34TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-1400
Practice Address - Country:US
Practice Address - Phone:512-323-6211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA410103TC0700X
NM642103TC0700X
TX33405103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0061PQOtherBCBS OF TX
TX0061PQOtherBCBS OF TX