Healthcare Provider Details

I. General information

NPI: 1730727033
Provider Name (Legal Business Name): GABRIELA ESCOBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2019
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3941 E COVELL RD
EDMOND OK
73034-6909
US

IV. Provider business mailing address

3941 E COVELL RD
EDMOND OK
73034-6909
US

V. Phone/Fax

Practice location:
  • Phone: 479-318-2300
  • Fax:
Mailing address:
  • Phone: 479-318-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number15-09069
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-84785
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: