MEDICARE: MARK GIBBONS MD

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	207Y00000X	Otolaryngology Physician	N0768	TX

General Provider Information

NPI Number	:	1952484784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK GIBBONS MD

Provider Business Mailing Address
First Line	:	1001 E AUSTIN ST
Second Line	:
City	:	PARIS
State	:	TX
Zip	:	75460-7483
Country	:	US
Telephone Number	:	903-785-5800
Fax Number	:	903-785-5821

Provider Business Practice Location Address
First Line	:	1001 E AUSTIN ST
Second Line	:
City	:	PARIS
State	:	TX
Zip	:	75460-7483
Country	:	US
Telephone Number	:	903-785-5800
Fax Number	:	903-785-5821

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	03/25/2026

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