Individual
MASON GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
2412 50TH ST, LUBBOCK, TX 79412
(806) 744-7223
(806) 740-3325
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(713) 620-4000
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
24570605
TX
Other
Enumeration date
05/22/2018
Last updated
08/30/2018
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