Provider Demographics
NPI:1841801594
Name:LE NOBEL, GAVIN JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:GAVIN
Middle Name:JOHN
Last Name:LE NOBEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14211 FM 2920 ROAD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377
Mailing Address - Country:US
Mailing Address - Phone:281-737-1910
Mailing Address - Fax:281-737-1911
Practice Address - Street 1:14211 FM 2920 ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377
Practice Address - Country:US
Practice Address - Phone:281-737-1910
Practice Address - Fax:281-737-1911
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2021-06-18
Deactivation Date:2021-05-28
Deactivation Code:
Reactivation Date:2021-06-18
Provider Licenses
StateLicense IDTaxonomies
TXS7086207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck