Individual
CHELSIE GIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4138 19TH ST, LUBBOCK, TX 79407-2403
(806) 780-2329
(806) 780-2330
Mailing address
2431 S LOOP 289, LUBBOCK, TX 79423-1519
(806) 771-7661
(806) 771-4190
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1203761
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
858T19
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/22/2011
Last updated
03/21/2011
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