Provider Demographics
NPI:1962686808
Name:MEDRANO VALLE, GABRIEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:A
Last Name:MEDRANO VALLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:UTHSCSA-DEPT. OF OB/GYN
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-567-5051
Mailing Address - Fax:210-567-4963
Practice Address - Street 1:527 N LEONA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3110
Practice Address - Country:US
Practice Address - Phone:210-358-3441
Practice Address - Fax:210-358-5944
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9503207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX194262501Medicaid
TX8K8266Medicare PIN
TX8L11281Medicare PIN