Provider Demographics
NPI:1932973369
Name:MAYES, AUBREY JOY
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:JOY
Last Name:MAYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:JOY
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:590 N KIMBALL AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6888
Mailing Address - Country:US
Mailing Address - Phone:817-973-5366
Mailing Address - Fax:817-973-5366
Practice Address - Street 1:590 N KIMBALL AVE STE 140
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6888
Practice Address - Country:US
Practice Address - Phone:817-973-5366
Practice Address - Fax:817-973-5366
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program