Active NPI
Gabriel Luis Polo, D.D.S.
- Dentist
- The Woodlands, TX
National Provider Identifier
1043401433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 16866
- Practice address
- 9420 College Park Dr
Suite # 230
The Woodlands, TX 77384-4516 - Phone
- (936) 271-3500
- Fax
- (936) 271-3503
- NPI assigned
- Aug 9, 2007
- Last updated
- Aug 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 16866 | TX | Primary |
Addresses
Primary practice location
9420 College Park Dr
Suite # 230
The Woodlands, TX 77384-4516
Mailing address
9420 College Park Dr
Suite # 230
The Woodlands, TX 77384-4516
Phone (936) 271-3500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16866 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TX Southern Dental PPO PC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186617600000",
"number": "1043401433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9420 COLLEGE PARK DR",
"address_2": "SUITE # 230",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "773844516",
"telephone_number": "936-271-3500",
"fax_number": "936-271-3503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9420 COLLEGE PARK DR",
"address_2": "SUITE # 230",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "773844516",
"telephone_number": "936-271-3500",
"fax_number": "936-271-3503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLO",
"first_name": "GABRIEL",
"middle_name": "LUIS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-09",
"last_updated": "2007-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "16866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in The Woodlands, TX
- Kathy Adriana Plascencia, LMHC, LPC
- Platinum Facial Surgical Group (Woodlands Oral and Facial Surgery Center)
- Platinum Plus Health Consultants PLLC
- Polaris Eeg and Diagnostics
- Elizabeth Davenport Pollock
- Candice Polochak Arrambide, FNP-C, ENP-C
- Riley Ponder, MSN, APRN, CPNP-PC
- David Nicholas Pope, DC
- Mauricio Porras Guridi, DPT
- Post-Acute Physicians of Texas PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.