Provider Demographics
NPI:1629641246
Name:GABRIEL A LEON SR LLC
Entity Type:Organization
Organization Name:GABRIEL A LEON SR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-430-1139
Mailing Address - Street 1:14651 SAIGON DR BLDG 42
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70129-1757
Mailing Address - Country:US
Mailing Address - Phone:504-430-1139
Mailing Address - Fax:
Practice Address - Street 1:14651 SAIGON DR BLDG 42
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70129-1757
Practice Address - Country:US
Practice Address - Phone:504-430-1139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)