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General NPI Number Information
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NPI Number | 1639202906
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Entity Type | Organization
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Legal Business Name | GWENDOLYN A. GIBBS
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 5331 W OREM DR
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City | HOUSTON
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State | TX
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Zip | 77045-5036
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Country | US
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Telephone | 713-433-0528
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Fax | 713-433-1462
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Provider Business Mailing Address
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Address Line | PO BOX 451485
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City | HOUSTON
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State | TX
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Zip | 77245-1485
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Country | US
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Telephone | 713-433-0528
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Fax | 713-433-1462
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Authorized Official
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Title or Position | CEO
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Name | GWENDOLYN ARNETTA GIBBS
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Credential |
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Telephone | 832-818-4443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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