Healthcare Provider Details

I. General information

NPI: 1083685960
Provider Name (Legal Business Name): CLAUDIA G. GABRIELLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CLAUDIA G TROMBLY MD

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 02/25/2020
Certification Date: 02/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 WATERS EDGE DR APT 324
LAKE DALLAS TX
75065-3090
US

IV. Provider business mailing address

201 S SHADY SHORES DR UNIT 1952
LAKE DALLAS TX
75065-5089
US

V. Phone/Fax

Practice location:
  • Phone: 469-475-6964
  • Fax: 469-375-3979
Mailing address:
  • Phone: 469-475-6964
  • Fax: 469-375-3979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberQ1603
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: