Individual
GABRIELLE MAVELIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5450 CLEARFORK MAIN ST STE 300, FORT WORTH, TX 76109-3514
(817) 334-1400
(817) 334-1410
Mailing address
5450 CLEARFORK MAIN ST STE 300, FORT WORTH, TX 76109-3514
(817) 334-1400
(817) 334-1410
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
S6447
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2017
Last updated
12/02/2020
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