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General NPI Number Information
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NPI Number | 1194745885
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Entity Type | Individual
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Provider Name | GEORGE RAYMOND GIBSON III D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 6300 LA CALMA DR STE 200
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City | AUSTIN
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State | TX
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Zip | 78752-3825
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Country | US
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Telephone | 512-452-8533
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Fax |
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Provider Business Mailing Address
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Address Line | 2955 ELDORADO PKWY STE 100
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City | FRISCO
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State | TX
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Zip | 75033-7202
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Country | US
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Telephone | 214-407-8668
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | P8586
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 02003009A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 005432
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License Number State | AZ
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