Provider Demographics
NPI:1477670321
Name:MATHIEU, GABRIELLE EVE (L AC)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:EVE
Last Name:MATHIEU
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 GLENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1133
Mailing Address - Country:US
Mailing Address - Phone:512-699-6493
Mailing Address - Fax:512-458-9840
Practice Address - Street 1:1408 GLENWOOD DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1133
Practice Address - Country:US
Practice Address - Phone:512-699-6493
Practice Address - Fax:512-458-9840
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00641171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist