Individual
MR. GREGORY LEE GILBREATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
755 N 11TH ST, SUITE P2200, BEAUMONT, TX 77702-1500
(409) 892-1192
(409) 923-5074
Mailing address
PO BOX 419, VIDOR, TX 77670-0419
(409) 783-1663
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
250154
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0189219D2
—
TX
05
—
146592401
—
TX
Enumeration date
05/18/2006
Last updated
03/03/2023
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