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Individual

LAYNE O. GENTRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6624 FANNIN ST, SUITE 1450, HOUSTON, TX 77030-2312
(713) 383-6882
(713) 799-9917
Mailing address
6624 FANNIN ST, SUITE 1450, HOUSTON, TX 77030-2312
(713) 383-6882
(713) 799-9917

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
E1588
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004406874
AETNA
TX
05
100114101
TX
01
440000033
MEDICARE RR
TX
01
89C791
BLUE CROSS
TX
Enumeration date
12/22/2006
Last updated
07/20/2010
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