Provider Demographics
NPI:1851328603
Name:CABRERA, ANTONIO GABRIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:GABRIEL
Last Name:CABRERA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:6621 FANNIN ST
Mailing Address - Street 2:MC-19345-C
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2303
Mailing Address - Country:US
Mailing Address - Phone:832-826-5662
Mailing Address - Fax:832-825-0165
Practice Address - Street 1:81 N MARIO CAPECCHI DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84113-1125
Practice Address - Country:US
Practice Address - Phone:801-213-3599
Practice Address - Fax:801-213-7778
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2021-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT11443290-12052080P0202X
TX429612080P0202X
ARE-45102080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L25493Medicare PIN