Provider Demographics
NPI:1710589627
Name:REGINO, GABRIEL II (FNP)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:REGINO
Suffix:II
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3522 OLD HOLLY DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1934
Mailing Address - Country:US
Mailing Address - Phone:832-622-2398
Mailing Address - Fax:
Practice Address - Street 1:17490 HIGHWAY 3 STE A200
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-3600
Practice Address - Country:US
Practice Address - Phone:281-672-7262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-15
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1019575363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily