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Individual

DR. DONALD E GIBBONS III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 W MAIN ST, EMERGENCY DEPARTMENT, LEWISVILLE, TX 75057-3629
(972) 420-1000
Mailing address
758 N LARRABEE ST, APT. 514, CHICAGO, IL 60610-6445
(773) 710-1654

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
336077005
IL
207P00000X
Emergency Medicine Physician
Primary
M4791
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
183312101
TX
05
183312102
TX
01
8W0733
BCBS
TX
01
P00364135
RAILROAD
TX
Enumeration date
07/06/2006
Last updated
08/10/2011
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