NPIMap

Individual provider Active NPI

Jay Gavvala, MD

  • Clinical Neurophysiology Physician
  • Houston, TX
National Provider Identifier
1427281310
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
Q7373 Issued in TX
Practice address
6410 Fannin St Ste 1014
Houston, TX 77030-5301
Phone
(832) 325-7080
NPI assigned
Aug 26, 2009
Last updated
Jun 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X Q7373 TX
Neurology Physician 2084N0400X 036.132043 IL
Clinical Neurophysiology Physician 2084N0600X 036.132043 IL
Clinical Neurophysiology Physician 2084N0600X Q7373 TX Primary
Epilepsy Physician 2084E0001X Q7373 TX

Addresses

Primary practice location

6410 Fannin St Ste 1014
Houston, TX 77030-5301

Mailing address

1133 John Freeman Blvd Ste 440D
Houston, TX 77030-2809
Phone (713) 500-7015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160425000609 TX Practitioner - Neurology 1052537883 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ut PhysiciansGroup PAC ID 2961732193, 206 clinicians

Practice addresses (Care Compare)

16100 S Fwy
Pearland, TX 77584-1895
Phone (713) 413-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.132043ILMDNeurology Physician
Q7373TXMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jun 13, 2016 Accepting new patients
Baylor College of Medicine CurrentSince Jun 13, 2016 Accepting new patients
Ut Physicians CurrentSince Oct 10, 2022 Accepting new patients
Baylor College of Medicine CurrentSince Jun 13, 2016 Accepting new patients
Baylor College of Medicine Neurology CurrentSince Jun 13, 2016 Accepting new patients

Locations

11920 Astoria Blvd
Ste 292
Houston, TX 77089
Phone (713) 486-7970

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

6410 Fannin St
Ste 1014
Houston, TX 77030
Phone (713) 500-7100

7200 Cambridge St
#9A
Houston, TX 77030
Phone (713) 798-6151

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

7200 Cambridge St
Fl 9
Houston, TX 77030
Phone (713) 798-2273

7200 Cambridge St
Ste 9A
Houston, TX 77030
Phone (713) 798-2273

16100 South Fwy
Pearland, TX 77584
Phone (713) 413-5000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1427281310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 JOHN FREEMAN BLVD STE 440D",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302809",
            "telephone_number": "713-500-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 1014",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770305301",
            "telephone_number": "832-325-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVVALA",
        "first_name": "JAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-26",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "Q7373",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036.132043",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "IL",
            "license": "036.132043",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "TX",
            "license": "Q7373",
            "primary": true
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "TX",
            "license": "Q7373",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.