Individual
LARRY WAYNE GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12330 PRESTON ROAD, DALLAS, TX 75230
(972) 341-3200
(972) 341-3225
Mailing address
12330 PRESTON ROAD, DALLAS, TX 75230
(972) 341-3200
(972) 341-3225
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
E3283
TX
Other
Enumeration date
03/13/2013
Last updated
03/13/2013
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