Individual
MIKE W GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
617 N EBRITE ST, MESQUITE, TX 75149-3453
(972) 850-9945
(972) 546-1872
Mailing address
617 N EBRITE ST, MESQUITE, TX 75149-3453
(972) 571-9273
(866) 496-5016
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
804211277
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326388711
—
TX
Enumeration date
10/04/2021
Last updated
05/06/2025
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