Provider Demographics
NPI:1467105585
Name:GADIBIA, ESTHER O
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:O
Last Name:GADIBIA
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 1:5661 MCCLELLAND ST
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-1847
Mailing Address - Country:US
Mailing Address - Phone:817-438-6600
Mailing Address - Fax:
Practice Address - Street 1:5661 MCCLELLAND ST
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-1847
Practice Address - Country:US
Practice Address - Phone:817-438-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician