Provider Demographics
NPI:1376816173
Name:THOMAS, GABRIEL STEVEN
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:STEVEN
Last Name:THOMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:GABRIEL
Other - Middle Name:S
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNIM
Mailing Address - Street 1:6860 DALLAS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-4242
Mailing Address - Country:US
Mailing Address - Phone:502-418-4426
Mailing Address - Fax:
Practice Address - Street 1:6860 DALLAS PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4242
Practice Address - Country:US
Practice Address - Phone:502-418-4426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-10
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3851246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7405Medicare PIN