Individual
DANIEL GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
22539 VALLEY CANYON LN, PORTER, TX 77365-7414
(936) 327-2031
Mailing address
22539 VALLEY CANYON LN, PORTER, TX 77365-7414
(936) 327-2031
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT5012
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT5012
LICENSED ATHLETIC TRAINER
TX
Enumeration date
12/05/2017
Last updated
12/05/2017
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