MR. GABRIEL S TELLEZ (NPI# 1629108881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629108881 |
| Entity Type | Individual |
| Full Name | MR. GABRIEL S TELLEZ |
| Credential | IDC |
| Practice Address |
1455 Ticonderoga Mcm Crew Fearless, Comcmron 2, Naval Station Ingleside TX 78362-5009 |
| Mailing Address |
1626 S 31st Dr Yuma AZ 85364-5021 |
| Practice Telephone | 7602719722 |
| Mailing Telephone | 7602719723 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
1455 TICONDEROGA MCM CREW FEARLESS, COMCMRON 2, NAVAL STATION |
| City | INGLESIDE |
| State | TX |
| Zip Code | 78362-5009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518488535 | Elizabeth Elmore | Physical Therapy Assistant | 2246 Sunset Cliffs Dr, Ingleside, TX 78362 | 2017-06-29 |
| 1699910414 | Benjamin Noel Paloy Carrido | Military Health Care Provider | 2969 Atlantic Blvd Apt 115, Ingleside, TX 78362 | 2008-12-08 |
| 1356438295 | Mayfield Chiropractic | Chiropractor | 2168 Hwy 361, Ingleside, TX 78362 | 2006-10-10 |
| 1881796274 | Stanley Dee Seymour | Chiropractor | 2681 State Hwy 361, Ingleside, TX 78362 | 2006-09-05 |
| 1306809967 | Douglas Neil Holleman Sr. | Military Health Care Provider | Mhc Crew Inflict, Naval Station Ingleside, Ingleside, TX 78362 | 2006-04-06 |
| 1619944642 | Damian J Lovello | Military Health Care Provider | 1632 Ticonderoga St, Uss Heron Mhc 52, Ingleside, TX 78362 | 2006-03-08 |
| 1720056609 | Rudy Wilbert Arocha | Military Health Care Provider | Branch Health Clinic, 327 Coral Sea Dr. Suite 165, Ingleside, TX 78362 | 2006-03-08 |
| 1518479930 | Candice Nicole Miller | Nurse Practitioner | 2713 S Main St, Ingleside, TX 78362 | 2017-10-25 |
| 1609043777 | Jason Paul Fechner | Military Health Care Provider | 1451 Lexington Drive, Comcmron2, Ingleside, TX 78362 | 2008-05-08 |
| 1487843975 | Wellmed Medical Group Pa | Clinic/Center | 2713 Main St, Ingleside, TX 78362 | 2007-10-19 |
| Find all providers in zip 78362 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699910414 | Benjamin Noel Paloy Carrido | Military Health Care Provider | 2969 Atlantic Blvd Apt 115, Ingleside, TX 78362 | 2008-12-08 |
| 1881844538 | Michael Charles Menninger | Military Health Care Provider | 1451 Lexington Blvd, Building 300, Suite 149, Ingleside, TX 78362-5015 | 2008-09-30 |
| 1891985529 | Roy Michael Elias | Military Health Care Provider | 327 Coral Sea Rd Suite 123, Ingleside, TX 78362-5025 | 2007-07-30 |
| 1245420017 | Phillip Anthony Rodriguez | Military Health Care Provider | Naval Branch Health Clinic Ingleside, 327 Coral Sea Drive, Suite 165, Ingleside, TX 78362-5025 | 2007-07-27 |
| 1306809967 | Douglas Neil Holleman Sr. | Military Health Care Provider | Mhc Crew Inflict, Naval Station Ingleside, Ingleside, TX 78362 | 2006-04-06 |
| 1619944642 | Damian J Lovello | Military Health Care Provider | 1632 Ticonderoga St, Uss Heron Mhc 52, Ingleside, TX 78362 | 2006-03-08 |
| 1326015389 | Emiliano Torres Jr. | Military Health Care Provider | 1451 Lexington Drive, Mcmron Two Medical, Ingleside, TX 78362-5055 | 2006-03-08 |
| 1720056609 | Rudy Wilbert Arocha | Military Health Care Provider | Branch Health Clinic, 327 Coral Sea Dr. Suite 165, Ingleside, TX 78362 | 2006-03-08 |
| 1609043777 | Jason Paul Fechner | Military Health Care Provider | 1451 Lexington Drive, Comcmron2, Ingleside, TX 78362 | 2008-05-08 |
| 1790970184 | Aaron Patrick Sikes | Military Health Care Provider | 327 Coral Sea Rd, Ingleside, TX 78362-5055 | 2007-09-10 |
| Find all providers in INGLESIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.