Individual
BRIAN MATTHEW TIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8230 WALNUT HILL LN STE 320, DALLAS, TX 75231-4481
(214) 369-5432
(214) 369-5591
Mailing address
8230 WALNUT HILL LN STE 320, DALLAS, TX 75231-4481
(214) 369-5432
(214) 369-5591
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2002005863
MO
208600000X
Surgery Physician
Primary
P9474
TX
2086S0102X
Surgical Critical Care Physician
P9474
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175956001
—
AR
05
—
20744506
—
MO
01
—
431560263
TRICARE WEST
MO
Enumeration date
06/07/2007
Last updated
09/30/2021
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