Provider Demographics
NPI:1215355029
Name:GABRIEL A. MAISLOS, PA
Entity type:Organization
Organization Name:GABRIEL A. MAISLOS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAISLOS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:713-541-3199
Mailing Address - Street 1:7777 SOUTHWEST FWY STE 506
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1816
Mailing Address - Country:US
Mailing Address - Phone:713-541-3199
Mailing Address - Fax:713-541-5809
Practice Address - Street 1:7777 SOUTHWEST FWY STE 506
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1816
Practice Address - Country:US
Practice Address - Phone:713-541-3199
Practice Address - Fax:713-541-5809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1576P213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU87586Medicare UPIN