Basic Information
| Provider Information | |||||||||
| NPI: | 1184979981 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ORGERON | ||||||||
| FirstName: | GABRIELA | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MOLINA ORDONEZ | ||||||||
| OtherFirstName: | MARIA | ||||||||
| OtherMiddleName: | GABRIELA | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 709 HOLLYBROOK DR STE 2301 | ||||||||
| Address2: | |||||||||
| City: | LONGVIEW | ||||||||
| State: | TX | ||||||||
| PostalCode: | 756052412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9037574691 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 709 HOLLYBROOK DR STE 2301 | ||||||||
| Address2: | |||||||||
| City: | LONGVIEW | ||||||||
| State: | TX | ||||||||
| PostalCode: | 756052412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9037574691 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2012 | ||||||||
| LastUpdateDate: | 11/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D0080983 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | S7523 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.