Provider Demographics
NPI:1891707204
Name:DURAND-HOLLIS, GABRIEL (MD)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:DURAND-HOLLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 THOMPSON DR
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5154
Mailing Address - Country:US
Mailing Address - Phone:830-896-2211
Mailing Address - Fax:830-258-5366
Practice Address - Street 1:1901 HIGHWAY 87 N
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-0283
Practice Address - Country:US
Practice Address - Phone:432-267-8216
Practice Address - Fax:432-268-7790
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE30002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0999401-02Medicaid
TX0999401-02Medicaid
TX87X243Medicare PIN