MEDICARE: GABRIELLE ALLISON POSZ OD

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
1	152W00000X	Optometrist	18004586A	IN

General Provider Information

NPI Number	:	1871480400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLE ALLISON POSZ OD

Provider Business Mailing Address
First Line	:	1355 W ALLEN ST APT 3
Second Line	:
City	:	BLOOMINGTON
State	:	IN
Zip	:	47403-3028
Country	:	US
Telephone Number	:	317-603-4807
Fax Number	:

Provider Business Practice Location Address
First Line	:	3051 GARDEN AVE STE 159
Second Line	:
City	:	JBSA FT SAM HOUSTON
State	:	TX
Zip	:	78234-7537
Country	:	US
Telephone Number	:	210-295-4362
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2025
Last Update Date	:	06/18/2025

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