Gabrielle Leysock

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA19019 Issued in TX

Practice address

1651 Rock Prairie Rd Ste 103
College Station, TX 77845-8652

Phone

(979) 314-5400

NPI assigned

Dec 13, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Premier Procedural Dermatology PLLC

  • MOHS-Micrographic Surgery Physician
  • College Station, TX
  • NPI 1053969287
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1124896774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 ROCK PRAIRIE RD STE 103",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458652",
            "telephone_number": "979-314-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 ROCK PRAIRIE RD STE 103",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458652",
            "telephone_number": "979-314-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEYSOCK",
        "first_name": "GABRIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-13",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA19019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Leveroni, LCSW
• Gwendolyn Levine, DVM
• Angela Lewis
• Danielle Ann Lewis, RBT
• Kieshia Lewis
• Yang Li, L.AC.
• Liberty Dialysis-College Station LLC
• Liberty Hearing Center- PLLC
• Candace Culpepper Light, D.D.S.
• Jennifer Light, DNP, APRN, CNM

• Medical Physician Assistant in College Station, TX
• Providers in College Station, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.