Basic Information
| Provider Information | |||||||||
| NPI: | 1891707204 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DURAND-HOLLIS | ||||||||
| FirstName: | GABRIEL | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 721 THOMPSON DR | ||||||||
| Address2: | |||||||||
| City: | KERRVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 780285154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8308962211 | ||||||||
| FaxNumber: | 8302585366 | ||||||||
| Practice Location | |||||||||
| Address1: | 1901 HIGHWAY 87 N | ||||||||
| Address2: | |||||||||
| City: | BIG SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 797200283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4322678216 | ||||||||
| FaxNumber: | 4322687790 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2006 | ||||||||
| LastUpdateDate: | 12/14/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | E3000 | TX | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 0999401-02 | 05 | TX | MEDICAID |