Provider Demographics
NPI:1073740080
Name:SCHLEBACH, GABRIEL RAY (PA-C)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:RAY
Last Name:SCHLEBACH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 93175
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-1175
Mailing Address - Country:US
Mailing Address - Phone:972-280-0080
Mailing Address - Fax:
Practice Address - Street 1:3901 W. 15TH
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75070-5169
Practice Address - Country:US
Practice Address - Phone:972-280-0080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical