Provider Demographics
NPI:1902264302
Name:FAJARDO, GABRIELA CRISTINA (PA)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:CRISTINA
Last Name:FAJARDO
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Gender:
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:4306 DE ZAVALA RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-4590
Mailing Address - Country:US
Mailing Address - Phone:210-450-4620
Mailing Address - Fax:210-450-6720
Practice Address - Street 1:4306 DE ZAVALA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-4590
Practice Address - Country:US
Practice Address - Phone:210-450-4620
Practice Address - Fax:210-450-6720
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA10442363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant