Provider Demographics
NPI:1093273633
Name:BARRIENTOS, GABRIELA (ATS)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:BARRIENTOS
Suffix:
Gender:F
Credentials:ATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17613 PICKERING RD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77302-6799
Mailing Address - Country:US
Mailing Address - Phone:936-217-4018
Mailing Address - Fax:
Practice Address - Street 1:22430 GRAND CORNER DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5718
Practice Address - Country:US
Practice Address - Phone:281-371-1850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-02
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X, 390200000X
TXAT89012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2000050406OtherCERTIFIED ATHLETIC TRAINER
TX8910OtherLICENSED ATHLETIC TRAINER