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General NPI Number Information
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NPI Number | 1386622827
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Entity Type | Individual
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Provider Name | MARK O GABBIE MD
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Gender | Male
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Dates
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Enumeration Date | 01/05/2006
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 3502 RICHMOND RD
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City | TEXARKANA
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State | TX
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Zip | 75503-0705
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Country | US
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Telephone | 903-614-5270
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 SAINT MICHAEL DR STE 401
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City | TEXARKANA
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State | TX
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Zip | 75503-5211
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Country | US
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Telephone | 903-614-5383
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Fax | 903-614-5343
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C7084
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H5885
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License Number State | TX
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