Marygayle Martin Radley, DO
Individual provider Active NPI Psychiatry Physician · Jbsa Lackland Afb, TX
NPI 1154940575 · NPPES record last updated Sep 23, 2025
Key facts
- NPI
- 1154940575
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 0102206920 (VA)
- Practice address
- 1100 Wilford Hall Loop
Jbsa Lackland Afb, TX 78236 - Phone
- (210) 292-7361
- NPI assigned
- Apr 15, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102206920 | VA | MD | Psychiatry Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0102206920 | VA | Yes |
Addresses
Primary practice location
1100 Wilford Hall Loop
Jbsa Lackland Afb, TX 78236
Mailing address
1100 Wilford Hall Loop
Jbsa Lackland Afb, TX 78236
Phone (210) 292-7361
Other practice location 1
3551 Roger Brooke Dr
JBSA Ft Sam Houston, TX 78234
Phone (210) 292-4141
Other names
- Marygayle Elizabeth Martin
Other providers in Jbsa Lackland Afb, TX
- Joanna Marliss Funk Nelms
- Duy Quoc Nguyen
- Jon Jason O'Pry
- Tiffney Peters
- Jennifer Nichole Phillips
- Farhan Raza
All providers in Jbsa Lackland Afb, TX · Psychiatry Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.