Provider Demographics
NPI:1497852024
Name:SOSA, GABRIEL JR (MPT)
Entity Type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:
Last Name:SOSA
Suffix:JR
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 N 23RD ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-6058
Mailing Address - Country:US
Mailing Address - Phone:956-618-2199
Mailing Address - Fax:956-618-0899
Practice Address - Street 1:3200 N 23RD ST STE 1
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-6058
Practice Address - Country:US
Practice Address - Phone:956-618-2199
Practice Address - Fax:956-618-0899
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1142057225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist