Provider Demographics
NPI:1215564497
Name:ABELLO, GABRIEL (LVN)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:ABELLO
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 NORMA LEIGH LN
Mailing Address - Street 2:
Mailing Address - City:GUN BARREL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75156-5189
Mailing Address - Country:US
Mailing Address - Phone:469-531-4972
Mailing Address - Fax:
Practice Address - Street 1:128 NORMA LEIGH LN
Practice Address - Street 2:
Practice Address - City:GUN BARREL CITY
Practice Address - State:TX
Practice Address - Zip Code:75156-5189
Practice Address - Country:US
Practice Address - Phone:469-531-4972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX351148164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse