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Individual
SAMUEL MARLIN GIBSON
Active
Individual
SAMUEL MARLIN GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1132587
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8T6765
BCBS OF TEXAS
TX
Enumeration date
09/24/2006
Last updated
10/09/2007
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