Provider Demographics
NPI:1972600831
Name:GAMBINO, MICHEL JOSEPH III (O D)
Entity Type:Individual
Prefix:DR
First Name:MICHEL
Middle Name:JOSEPH
Last Name:GAMBINO
Suffix:III
Gender:M
Credentials:O D
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Mailing Address - Street 1:14586 BERKLEE DR
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3532
Mailing Address - Country:US
Mailing Address - Phone:972-386-9646
Mailing Address - Fax:972-386-3371
Practice Address - Street 1:4150 BELT LINE RD
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4354
Practice Address - Country:US
Practice Address - Phone:972-386-9646
Practice Address - Fax:972-386-3371
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX4387T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist