Individual provider Active NPI

Gail Tyria Houston, PA-C

  • Medical Physician Assistant
  • Fort Leavenworth, KS
National Provider Identifier
1316929888
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C100031 Issued in MD
Practice address
210 Grant Ave
Room 1809
Fort Leavenworth, KS 66027-1231
Phone
(913) 758-3791
NPI assigned
Nov 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C100031 MD Primary

Addresses

Primary practice location

210 Grant Ave
Room 1809
Fort Leavenworth, KS 66027-1231

Mailing address

2412 Mountain Rd
Joppa, MD 21085-2338
Phone (410) 262-4305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C100031MDMDMedical Physician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316929888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 MOUNTAIN RD",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210852338",
            "telephone_number": "410-262-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 GRANT AVE",
            "address_2": "ROOM 1809",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "660271231",
            "telephone_number": "913-758-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSTON",
        "first_name": "GAIL",
        "middle_name": "TYRIA",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C100031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Leavenworth, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.