Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | P1866 | TX |
NPI | 1003997099 |
---|---|
Provider Name | Janice Lynn Gibbons |
First Address | Paris, TX 75460-8076 |
Second Address | Paris, TX 75460-8076 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 17/04/2015 |