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General NPI Number Information
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NPI Number | 1912196577
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Entity Type | Organization
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Legal Business Name | GWENDOLYN GIBBS
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Dates
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Enumeration Date | 10/19/2007
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Last Update Date | 10/19/2007
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Provider Practice Location Address
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Address Line | 9000 SOUTHWEST FWY SUITE 400
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City | HOUSTON
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State | TX
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Zip | 77074-1526
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Country | US
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Telephone | 713-270-0764
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Fax | 713-270-7999
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Provider Business Mailing Address
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Address Line | 9000 SOUTHWEST FWY SUITE 400
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City | HOUSTON
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State | TX
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Zip | 77074-1526
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Country | US
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Telephone | 713-270-0764
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Fax | 713-270-7999
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Authorized Official
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Title or Position | OWNER
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Name | MS. GWENDOLYN A GIBBS
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Credential |
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Telephone | 281-208-3798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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