Individual provider Active NPI

Gabriel Grace McGuire

  • Family Nurse Practitioner
  • Texarkana, TX
National Provider Identifier
1790506780
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1105976 Issued in TX
Practice address
2101 Galleria Oaks Dr
Texarkana, TX 75503-4625
Phone
(903) 791-9120
NPI assigned
Oct 22, 2024
Last updated
Oct 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1105976 TX Primary

Addresses

Primary practice location

2101 Galleria Oaks Dr
Texarkana, TX 75503-4625

Mailing address

2101 Galleria Oaks Dr
Texarkana, TX 75503-4625
Phone (903) 791-9120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241114000495 TX Practitioner - Nurse Practitioner 8729512652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medical Group of TexarkanaGroup PAC ID 3870485626, 12 clinicians

Practice addresses (Care Compare)

2101 Galleria Oaks Dr
Texarkana, TX 75503-4625
Phone (903) 791-9120

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Group of Texarkana CurrentSince Nov 1, 2024 Accepting new patients

Locations

2101 Galleria Oaks Dr
Texarkana, TX 75503
Phone (903) 791-9120

5212 W 7th St
Wake Village, TX 75501
Phone (903) 791-9120

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1790506780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 GALLERIA OAKS DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034625",
            "telephone_number": "903-791-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 GALLERIA OAKS DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034625",
            "telephone_number": "903-791-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGUIRE",
        "first_name": "GABRIEL",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1105976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.