Provider Demographics
NPI:1639787575
Name:GEORGE, GABRIELLE IRIS MARIE (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:IRIS MARIE
Last Name:GEORGE
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11507 STARLIGHT BAY CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8281
Mailing Address - Country:US
Mailing Address - Phone:832-287-0885
Mailing Address - Fax:
Practice Address - Street 1:11507 STARLIGHT BAY CT
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8281
Practice Address - Country:US
Practice Address - Phone:832-287-0885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120965225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics