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General NPI Number Information
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NPI Number | 1407239494
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Entity Type | Organization
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Legal Business Name | SARAH E. GIBSON, O.D., P.A.
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Dates
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Enumeration Date | 07/08/2015
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Last Update Date | 08/26/2016
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Provider Practice Location Address
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Address Line | 3313 RANCH ROAD 620 S STE 200
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City | AUSTIN
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State | TX
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Zip | 78738-6871
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Country | US
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Telephone | 832-578-8533
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Fax |
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Provider Business Mailing Address
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Address Line | 3313 RR 620 S STE 200
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City | AUSTIN
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State | TX
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Zip | 78738-6871
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Country | US
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Telephone | 512-263-3550
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | SARAH GIBSON
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Credential | O.D.
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Telephone | 512-263-3550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7839
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License Number State | TX
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