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NPI 1992821037

NPI 1992821037 : CHANDRA YVETTE GIBBS O.D. : RICHARDSON, TX

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General NPI Number Information
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    NPI Number           |    1992821037
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    Entity Type          |    Individual 
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    Provider Name        |    CHANDRA YVETTE GIBBS O.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/21/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    601 S PLANO RD 
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    City                 |    RICHARDSON
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    State                |    TX
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    Zip                  |    75081-4512
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    Country              |    US
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    Telephone            |    972-234-4860
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6108 WHITE PINE DR 
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    City                 |    MCKINNEY
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    State                |    TX
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    Zip                  |    75070-9508
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    Country              |    US
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    Telephone            |    972-886-2798
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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       |    6004T
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    License Number State |    TX
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