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Contact Information

GWEN E FAGALA BLAKE, MD
400 HARBORSIDE DR STE 118-119
GALVESTON, TX77555-1990
 Phone: 409-772-0770
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for GWEN E FAGALA BLAKE · (Female)

NPI Number 1801856158
Status Active
Credentials MD
Entity Individual
Enumeration date 03/23/2006
Last updated 01/09/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • TX License # H8027
Hospital affiliation(s)
  • UNIVERSITY OF TEXAS MEDICAL BRANCH GAL - (Acute Care)
    301 UNIVERSITY BOULEVARD
    GALVESTON, TX 77555
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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