Provider Demographics
NPI:1407492317
Name:GARDNER, GABRIELA (RD-AP, LD, CNSC)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:GARDNER
Suffix:
Gender:F
Credentials:RD-AP, LD, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6431 FANNIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6500 WEST LOOP S STE 200
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3535
Practice Address - Country:US
Practice Address - Phone:713-572-8122
Practice Address - Fax:713-383-1462
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-26
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT81845133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered