Provider Demographics
NPI:1992372981
Name:GAPS COLLABORATIVE TX
Entity Type:Organization
Organization Name:GAPS COLLABORATIVE TX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YITTY
Authorized Official - Middle Name:
Authorized Official - Last Name:FALKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-734-6621
Mailing Address - Street 1:250 SKILLMAN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-1218
Mailing Address - Country:US
Mailing Address - Phone:212-734-6621
Mailing Address - Fax:
Practice Address - Street 1:3301 VIEW ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76103-2425
Practice Address - Country:US
Practice Address - Phone:212-734-6621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty