Basic Information
| Provider Information | |||||||||
| NPI: | 1538119995 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JAMES B GABROY MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1535 W. WARM SPRINGS ROAD | ||||||||
| Address2: | SUITE 135 | ||||||||
| City: | HENDERSON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024503385 | ||||||||
| FaxNumber: | 7028981699 | ||||||||
| Practice Location | |||||||||
| Address1: | 1535 W. WARM SPRINGS ROAD | ||||||||
| Address2: | SUITE 135 | ||||||||
| City: | HENDERSON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024503385 | ||||||||
| FaxNumber: | 7028981699 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2006 | ||||||||
| LastUpdateDate: | 06/06/2016 | ||||||||
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| AuthorizedOfficialLastName: | GABROY | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7024503385 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | NV7601 | NV | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 002002205 | 05 | NV | MEDICAID |