Provider Demographics
NPI:1821403809
Name:DELA CRUZ, KRISTOPHER GABAS (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTOPHER
Middle Name:GABAS
Last Name:DELA CRUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2801 MACARTHUR DR STE E
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-4791
Mailing Address - Country:US
Mailing Address - Phone:409-920-4037
Mailing Address - Fax:409-727-5933
Practice Address - Street 1:2801 MACARTHUR DR STE E
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-4791
Practice Address - Country:US
Practice Address - Phone:409-920-4037
Practice Address - Fax:409-727-5933
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXR1944207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR1944OtherTEXAS MEDICAL LICENSE