Organization
GIBSON PHARMACY
Active
Organization
GIBSON PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY RAY (PHARMACIST)
(972) 264-0268
Entity
Organization
Contact information
Practice address
2505 S CARRIER PKWY, GRAND PRAIRIE, TX 75052-5017
(972) 264-0268
(972) 262-1750
Mailing address
2505 S CARRIER PKWY, GRAND PRAIRIE, TX 75052-5017
(972) 264-0268
(972) 262-1750
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
05040
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141836
—
TX
Enumeration date
10/03/2006
Last updated
12/17/2019
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