Provider Demographics
NPI:1316534159
Name:MURGUIA, GABRIELLE ELISE
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:ELISE
Last Name:MURGUIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 PARKHILL DR
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-9105
Mailing Address - Country:US
Mailing Address - Phone:832-725-3242
Mailing Address - Fax:
Practice Address - Street 1:208 PARKHILL DR
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-9105
Practice Address - Country:US
Practice Address - Phone:832-725-3242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34506915171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator