Provider Demographics
NPI:1861434334
Name:GABRIEL, HODA R (MD)
Entity type:Individual
Prefix:DR
First Name:HODA
Middle Name:R
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 TEZEL RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-4183
Mailing Address - Country:US
Mailing Address - Phone:210-681-5117
Mailing Address - Fax:210-523-1734
Practice Address - Street 1:6750 TEZEL RD
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-4183
Practice Address - Country:US
Practice Address - Phone:210-681-5117
Practice Address - Fax:210-523-1734
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5906208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000A52K5Medicaid
TXP000A52K5Medicaid