Provider Demographics
NPI:1538228002
Name:MAY, LARRY (PA)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:
Last Name:MAY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 WINCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-7804
Mailing Address - Country:US
Mailing Address - Phone:512-344-9715
Mailing Address - Fax:512-369-3366
Practice Address - Street 1:4316 JAMES CASEY ST
Practice Address - Street 2:BLDG B STE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1116
Practice Address - Country:US
Practice Address - Phone:512-498-1029
Practice Address - Fax:512-369-3366
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00488363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical