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General NPI Number Information
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NPI Number | 1467846931
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Entity Type | Individual
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Provider Name | SARAH GIBSON O.D.
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Gender | Female
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Dates
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Enumeration Date | 03/23/2015
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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
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City | AUSTIN
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State | TX
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Zip | 78738-6870
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Country | US
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Telephone | 512-263-3550
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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 |
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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 | 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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