Provider Demographics
NPI:1255759098
Name:ORTIZ-VARELA, GABRIEL (MD)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:ORTIZ-VARELA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GABE
Other - Middle Name:
Other - Last Name:ORTIZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4411 E. SOUTHCROSS BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222
Mailing Address - Country:US
Mailing Address - Phone:210-648-9500
Mailing Address - Fax:
Practice Address - Street 1:4411 E SOUTHCROSS BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-3726
Practice Address - Country:US
Practice Address - Phone:210-648-9500
Practice Address - Fax:210-648-9504
Is Sole Proprietor?:No
Enumeration Date:2014-03-30
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPHYTEMP207R00000X
TXR4121207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine