Organization
P A CORPORATE ENTERPRISES LLP
Active
Other names
South Gibson Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID JEFF WILBERT PA-C (OWNER)
(713) 462-0000
Entity
Organization
Contact information
Practice address
589 HIGHWAY 45 BYP S, MEDINA, TN 38355-9633
(713) 462-0000
Mailing address
589 HIGHWAY 45 BYP S, MEDINA, TN 38355-9633
(713) 462-0000
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
01/06/2017
Last updated
06/21/2021
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