Provider Demographics
NPI:1538119995
Name:JAMES B GABROY MD INC
Entity Type:Organization
Organization Name:JAMES B GABROY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:GABROY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-450-3385
Mailing Address - Street 1:1535 W. WARM SPRINGS ROAD
Mailing Address - Street 2:SUITE 135
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014
Mailing Address - Country:US
Mailing Address - Phone:702-450-3385
Mailing Address - Fax:702-898-1699
Practice Address - Street 1:1535 W. WARM SPRINGS ROAD
Practice Address - Street 2:SUITE 135
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014
Practice Address - Country:US
Practice Address - Phone:702-450-3385
Practice Address - Fax:702-898-1699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV7601207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002002205Medicaid
B99496Medicare UPIN
NVV101807Medicare ID - Type Unspecified