MEDICARE: DR. ALFRED EARL GIBBONS JR. 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	174400000X	Specialist	E4846	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00T591	OTHER	TX	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1922118314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALFRED EARL GIBBONS JR. M. D

Provider Business Mailing Address
First Line	:	3115 PINE AVE
Second Line	:	SUITE 301
City	:	WACO
State	:	TX
Zip	:	76708-3247
Country	:	US
Telephone Number	:	254-756-7044
Fax Number	:	254-756-3779

Provider Business Practice Location Address
First Line	:	3115 PINE AVE
Second Line	:	SUITE 301
City	:	WACO
State	:	TX
Zip	:	76708-3247
Country	:	US
Telephone Number	:	254-756-7044
Fax Number	:	254-756-3779

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1871583773 — DIANNE WADDELL SAWYER MD
Practice Location Address:

3115 PINE AVE , STE 903
WACO, TX
76708-3247

Practice Phone: 254-753-5858
Practice Fax: 254-753-5883

1811001951 — ROBERT A.M. GARDERE M.D.
Practice Location Address:

3115 PINE AVE , STE#908
WACO, TX
76708-3247

Practice Phone: 254-752-2575
Practice Fax: 254-752-0188

1629175369 — JEFFREY JOSEPH LEINFELDER M.D.
Practice Location Address:

3115 PINE AVE , SUITE 202
WACO, TX
76708-3247

Practice Phone: 254-752-8328
Practice Fax: 254-752-7724

1710084447 — LEWIS RICHARD KANNWISCHER M.D.
Practice Location Address:

3115 PINE AVE , SUITE 202
WACO, TX
76708-3247

Practice Phone: 254-752-8328
Practice Fax: 254-752-7724

1891870242 — WACO PEDIATRIC HEALTH ASSOCIATES
Practice Location Address:

3115 PINE AVE , 1006
WACO, TX
76708-3247

Practice Phone: 254-756-6836
Practice Fax: 254-756-6865

1164551420 — MS. LINDA ELLEN BRANZ N.P.
Practice Location Address:

3115 PINE AVE , SUITE 708
WACO, TX
76708-3247

Practice Phone: 254-754-0300
Practice Fax: 254-754-0301

Directions to “ DR. ALFRED EARL GIBBONS JR. M. D” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.