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General NPI Number Information
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NPI Number | 1497907331
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Entity Type | Organization
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Legal Business Name | GIBBONS EYE CARE, P.C.
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 10/22/2008
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Provider Practice Location Address
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Address Line | 1670 W UNIVERSITY DR
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City | MCKINNEY
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State | TX
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Zip | 75069-3444
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Country | US
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Telephone | 972-548-2633
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Fax | 972-548-2638
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Provider Business Mailing Address
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Address Line | 2114 HANAKOA FALLS DR
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City | ANNA
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State | TX
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Zip | 75409-5129
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Country | US
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Telephone | 469-247-6477
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Fax | 972-548-2638
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. TYLER E. GIBBONS
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Credential | O.D.
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Telephone | 972-548-2633
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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 |
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License Number State |
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