Provider Demographics
NPI:1154633071
Name:COLON-ATENCIO, GABRIEL ORLANDO
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:ORLANDO
Last Name:COLON-ATENCIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 S CLEAR CREEK RD
Mailing Address - Street 2:STE. 126
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-4143
Mailing Address - Country:US
Mailing Address - Phone:254-554-3003
Mailing Address - Fax:254-554-8362
Practice Address - Street 1:2301 S CLEAR CREEK RD
Practice Address - Street 2:STE. 126
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4143
Practice Address - Country:US
Practice Address - Phone:254-554-3003
Practice Address - Fax:254-554-8362
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other