MEDICARE: BURNEY WILLIAM GIBSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	E4351	TX
2	207L00000X	Anesthesiology Physician	C37722	CA
3	207L00000X	Anesthesiology Physician	23736	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801889910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BURNEY WILLIAM GIBSON M.D.

Provider Business Mailing Address
First Line	:	13601 PRESTON RD
Second Line	:	SUITE 900W
City	:	DALLAS
State	:	TX
Zip	:	75240-4911
Country	:	US
Telephone Number	:	972-233-1999
Fax Number	:

Provider Business Practice Location Address
First Line	:	13601 PRESTON RD
Second Line	:	SUITE 900W
City	:	DALLAS
State	:	TX
Zip	:	75240-4911
Country	:	US
Telephone Number	:	972-233-1999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	11/18/2008

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Directions to “ BURNEY WILLIAM GIBSON M.D.” Practice Location

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