Individual
JAKE ALAN GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3500 GASTON AVE, DALLAS, TX 75246-2017
(214) 820-2361
Mailing address
3500 GASTON AVE, DALLAS, TX 75246-2017
(214) 820-2361
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
T7567
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2019
Last updated
03/10/2025
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