Individual
CARLA DIANE GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2701 HOSPITAL DR, VICTORIA, TX 77901-5748
(361) 573-9181
(361) 572-5126
Mailing address
2701 HOSPITAL DR, VICTORIA, TX 77901-5748
(361) 573-9181
(361) 572-5126
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06556
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213213601
—
TX
01
—
821N72
BLUE CROSS
TX
01
—
8L26631
MEDICARE PTAN
TX
Enumeration date
03/08/2010
Last updated
04/13/2011
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