Provider Demographics
NPI:1023905734
Name:VELASAQUEZ, GABRIELLA (RBT)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:
Last Name:VELASAQUEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 OAK CREEK LN APT A
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-8957
Mailing Address - Country:US
Mailing Address - Phone:817-724-7062
Mailing Address - Fax:
Practice Address - Street 1:4900 ORIEN ST
Practice Address - Street 2:
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76117-3149
Practice Address - Country:US
Practice Address - Phone:817-724-7062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-22-2323312080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics