Dr. Jeremy L. Gibson
Pediatrician
2401 S 31st St
Temple
, Texas 76508-0001
Dr. Jeremy L. Gibson
Pediatrician
2401 S 31st St
Temple
, Texas 76508-0001
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About
Features
Specialties
- Pediatrician
Languages spoken
- English
Location
First Address
- Dr. Jeremy L. Gibson
- Po Box 844658
- Dallas, TX
- Zip : 75284-4658
- Phone :
Second Address
- Dr. Jeremy L. Gibson
- 2401 S 31st St
- Temple, TX
- Zip : 76508-0001
- Phone : (254) 724-2111
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208000000X | Pediatrician | K9540 | TX |
National Provider Identifier
| NPI | 1003876798 |
|---|---|
| Provider Name | Dr. Jeremy L. Gibson |
| First Address | Dallas, TX 75284-4658 |
| Second Address | Temple, TX 76508-0001 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/03/2006 |
| Last Update Date | 17/12/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1446577-01 | (05) | TX |
| 1446577-02 | CSHCN (01) | TX |
| 370019198 | RR/MEDICARE (01) | TX |
| 8B4705 | BLUE SHIELD (01) | TX |
| H41408 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.