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General NPI Number Information
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NPI Number | 1629761549
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Entity Type | Individual
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Provider Name | ANTHONY E GIBSON SR.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2023
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 777 MAIN ST STE 600
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City | FORT WORTH
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State | TX
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Zip | 76102-5368
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Country | US
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Telephone | 817-909-5157
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Fax |
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Provider Business Mailing Address
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Address Line | 4516 WILLOW ROCK LN
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City | FORT WORTH
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State | TX
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Zip | 76244-4332
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Country | US
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Telephone | 817-909-5157
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 374700000X
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Taxonomy Name | Technician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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