Provider Demographics
NPI:1689956906
Name:CEBALLOS, GILDARDO (MD)
Entity type:Individual
Prefix:
First Name:GILDARDO
Middle Name:
Last Name:CEBALLOS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11606 WESTMOOR DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2990
Mailing Address - Country:US
Mailing Address - Phone:713-468-0880
Mailing Address - Fax:713-234-4018
Practice Address - Street 1:6410 HWY 90 ALT
Practice Address - Street 2:SUITE D
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:713-468-0880
Practice Address - Fax:713-234-4018
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0357207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine