Individual
DR. ANGELA MICHELLE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4100 EVERETT DR, SUITE 400, KYLE, TX 78640-6146
(512) 295-1333
(512) 406-7327
Mailing address
4515 SETON CENTER PARKWAY, SUITE 215-CREDENTIALING, AUSTIN, TX 78759-5785
(512) 231-5548
(512) 406-6216
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L3310
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1541278-01
—
TX
05
—
154127805
—
TX
05
—
154127806
—
TX
01
—
8B5305
BC/BS
TX
Enumeration date
04/21/2006
Last updated
08/02/2016
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