Provider Demographics
NPI:1083761829
Name:REY, GABRIELA (DDS)
Entity Type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:
Last Name:REY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 PRESA PL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-5603
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3301 PERA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2313
Practice Address - Country:US
Practice Address - Phone:915-313-8000
Practice Address - Fax:915-313-8031
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21272122300000X
TX19933122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145034802Medicaid
TX145034804Medicaid
TX145034803Medicaid
MA0206091Medicaid