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Individual
DR. GABRIEL ALEXANDER MAISLOS
Active
Individual
DR. GABRIEL ALEXANDER MAISLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1576
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
1576P
TX
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10012478
AMERIGROUP
TX
05
—
147117902
—
TX
01
—
51KM
BLUE CROSS BLUE SHIELD
TX
Enumeration date
09/20/2006
Last updated
05/04/2021
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