Individual
GIBBS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1605 SOUTH 31ST STREET, TEMPLE, TX 76508-1978
(254) 215-0100
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
593787
TX
207R00000X
Internal Medicine Physician
R2254
TX
207RC0000X
Cardiovascular Disease Physician
Primary
R2254
TX
Other
Enumeration date
05/12/2015
Last updated
07/20/2021
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