Individual
GUSHYALATHA BOYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1401 MEDICAL PKWY STE 220, CEDAR PARK, TX 78613-5013
(512) 324-4083
(512) 324-4717
Mailing address
PO BOX 26726, AUSTIN, TX 78755-0726
(512) 407-8686
(512) 406-6216
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP1-0026596
TX
207R00000X
Internal Medicine Physician
Primary
N2011
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280010401
—
TX
05
—
280010402
—
TX
05
—
280010403
—
TX
01
—
3853840484
MYUTMB 3853840484-COMMERCIAL NUMBER
—
Enumeration date
06/14/2007
Last updated
02/11/2022
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