Provider Demographics
NPI:1568031656
Name:DAVILA, GABRIEL I (OD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:I
Last Name:DAVILA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3800 N MESA ST STE B1
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1535
Mailing Address - Country:US
Mailing Address - Phone:915-533-1811
Mailing Address - Fax:915-533-3641
Practice Address - Street 1:3800 N MESA ST STE B1
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-1535
Practice Address - Country:US
Practice Address - Phone:915-533-1811
Practice Address - Fax:915-533-3641
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10268152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist