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General NPI Number Information
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NPI Number | 1003063785
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Entity Type | Organization
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Legal Business Name | RAY N GIBSON, DO
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Dates
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Enumeration Date | 08/25/2008
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Last Update Date | 08/25/2008
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Provider Practice Location Address
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Address Line | 101 AVENUE J
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City | ANSON
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State | TX
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Zip | 79501-2113
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Country | US
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Telephone | 325-823-3231
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Fax | 325-823-3098
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Provider Business Mailing Address
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Address Line | 101 AVENUE J
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City | ANSON
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State | TX
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Zip | 79501-2113
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Country | US
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Telephone | 325-823-3231
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Fax | 325-823-3098
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Authorized Official
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Title or Position | OWNER
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Name | RAY N GIBSON
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Credential | DO
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Telephone | 325-823-3231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | TXF9477
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License Number State | TX
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