Active NPI
Marian Gaviola, PHARMD
- Critical Care Pharmacist
- Fort Worth, TX
National Provider Identifier
1659907517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pharmacist
- License
- 57095
- Practice address
- 3500 Camp Bowie Blvd
Fort Worth, TX 76107-2644 - Phone
- (817) 735-2252
- NPI assigned
- Mar 22, 2020
- Last updated
- Mar 22, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Critical Care Pharmacist | 1835C0205X | 57095 | TX | Primary |
Addresses
Primary practice location
3500 Camp Bowie Blvd
Fort Worth, TX 76107-2644
Mailing address
3500 Camp Bowie Blvd
Fort Worth, TX 76107-2644
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57095 | TX | MD | Critical Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584835200000",
"number": "1659907517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 CAMP BOWIE BLVD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761072644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 CAMP BOWIE BLVD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761072644",
"telephone_number": "817-735-2252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAVIOLA",
"first_name": "MARIAN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-22",
"last_updated": "2020-03-22",
"certification_date": "2020-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "1835C0205X",
"taxonomy_group": "",
"desc": "Pharmacist, Critical Care",
"state": "TX",
"license": "57095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.