Provider Demographics
NPI:1013191907
Name:GABRIEL A. MAISLOS, PA
Entity Type:Organization
Organization Name:GABRIEL A. MAISLOS, PA
Other - Org Name:HOUSTON FOOT AND ANKLE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAISLOS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:713-541-3199
Mailing Address - Street 1:2900 WESLAYAN ST STE 650
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5132
Mailing Address - Country:US
Mailing Address - Phone:713-541-3199
Mailing Address - Fax:713-541-5809
Practice Address - Street 1:2900 WESLAYAN ST STE 650
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5132
Practice Address - Country:US
Practice Address - Phone:713-541-3199
Practice Address - Fax:713-541-5809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1576213E00000X
TX1576P332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147117902Medicaid
TXU87586Medicare UPIN
TX147117902Medicaid
TX147117902Medicaid