Basic Information
Provider Information
NPI: 1639191133
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GABEL
FirstName: GEORGE
MiddleName: CLIFFORD
NamePrefix:  
NameSuffix: JR.
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2 E GREENWAY PLZ
Address2: SUITE 900
City: HOUSTON
State: TX
PostalCode: 770460297
CountryCode: US
TelephoneNumber: 7137981750
FaxNumber: 7137981144
Practice Location
Address1: 6620 MAIN ST
Address2:  
City: HOUSTON
State: TX
PostalCode: 770302348
CountryCode: US
TelephoneNumber: 7137981510
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/24/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XPA01394TXY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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