Individual
CHANCE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
438 W. ILLINOIS AVE, DALLAS, TX 75224
(214) 941-1197
Mailing address
438 W. ILLINOIS AVE, DALLAS, TX 75224
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
42160
TX
Other
Enumeration date
11/19/2009
Last updated
11/19/2009
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