Healthcare Provider Details

I. General information

NPI: 1659089522
Provider Name (Legal Business Name): GABRIELLE CUADRA MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2022
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S 24TH AVE
EDINBURG TX
78539-6533
US

IV. Provider business mailing address

1961 SABAL PALM DR
MERCEDES TX
78570-9342
US

V. Phone/Fax

Practice location:
  • Phone: 956-289-7298
  • Fax: 956-289-7257
Mailing address:
  • Phone: 956-650-1906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88991
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number88991
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: