Provider Demographics
NPI:1821403809
Name:DELA CRUZ, KRISTOPHER GABAS (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTOPHER
Middle Name:GABAS
Last Name:DELA CRUZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3712 GULFWAY DR
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-2828
Mailing Address - Country:US
Mailing Address - Phone:409-332-4300
Mailing Address - Fax:409-727-5933
Practice Address - Street 1:2400 HIGHWAY 365 STE 108
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-6268
Practice Address - Country:US
Practice Address - Phone:409-727-2808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR1944207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR1944OtherTEXAS MEDICAL LICENSE
TX379143601Medicaid