Individual
CAROL DENISE GIBBS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1005 MIDWESTERN PKWY, WICHITA FALLS, TX 76302-2211
(940) 322-0771
(940) 766-4943
Mailing address
1005 MIDWESTERN PKWY, WICHITA FALLS, TX 76302-2211
(940) 322-0771
(940) 766-4943
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
17269
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0058868
BLUE LINK #
TX
01
—
125054
SUPERIOR ID #
TX
01
—
17269
HUMANA ID #
TX
01
—
83375T
BCBS PROVIDER #
TX
Enumeration date
12/07/2005
Last updated
07/08/2007
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