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NPI Code Detail

MEDICARE: MR. DAVID ALLEN GABLE ATC, LAT, CSCS

MEDICARE:  MR. DAVID ALLEN GABLE  ATC, LAT, CSCS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic TrainerAT3085TX

General Provider Information

NPI Number : 1053435479
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID ALLEN GABLE ATC, LAT, CSCS
Provider Business Mailing Address
First Line : 3008 BALD EAGLE COURT
Second Line :
City : LAKESIDE
State : TX
Zip : 76135
Country : US
Telephone Number : 817-257-7984
Fax Number : 817-257-7323
Provider Business Practice Location Address
First Line : 3500 BELLAIRE DR N
Second Line :
City : FORT WORTH
State : TX
Zip : 76129-0001
Country : US
Telephone Number : 817-343-1384
Fax Number : 817-257-7323
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 07/08/2007

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Directions to “ MR. DAVID ALLEN GABLE ATC, LAT, CSCS” Practice Location

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