Individual
MRS. UN SUK GILBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSA, CST/FA
Contact information
Practice address
5500 39TH STREET, GROVES, TX 77619-2905
(409) 963-5265
(409) 963-1531
Mailing address
4400 INDIAN FALL DRIVE, PORT ARTHUR, TX 77642
(409) 293-1712
(409) 963-1531
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
CERTIFICATE# 00F652
TX
246ZS0410X
Surgical Technologist
SA00174
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0053LF
BLUE CROSS BLUE SHIELD OF TEXAS
TX
Enumeration date
08/21/2007
Last updated
01/13/2011
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