MEDICARE: DR. SARAH GIBSON O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	7839	TX

General Provider Information

NPI Number	:	1467846931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH GIBSON O.D.

Provider Business Mailing Address
First Line	:	3313 RR 620 S STE 200
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78738-6871
Country	:	US
Telephone Number	:	512-263-3550
Fax Number	:

Provider Business Practice Location Address
First Line	:	3313 RANCH ROAD 620 S
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78738-6870
Country	:	US
Telephone Number	:	512-263-3550
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2015
Last Update Date	:	08/26/2016

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Directions to “ DR. SARAH GIBSON O.D.” Practice Location

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