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
- 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 and National Provider Directory roles.
-
- Dentist
- Conroe, TX
- NPI 1306616867
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
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- 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.