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General NPI Number Information
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NPI Number | 1871034116
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Entity Type | Individual
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Provider Name | SEAN GAMBLE MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2017
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Last Update Date | 02/23/2025
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Provider Practice Location Address
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Address Line | 3551 ROGER BROOKE DR
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 210-916-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 503 AVENUE A APT 1333
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City | SAN ANTONIO
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State | TX
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Zip | 78215-1276
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Country | US
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Telephone | 762-333-5759
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | V3299
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License Number State | TX
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