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Individual

DEIDRE BIBB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1814 ROSELAND BLVD STE 100, TYLER, TX 75701-4262
(903) 525-3300
Mailing address
102 S STEWART ST, WHITE OAK, TX 75693-1514
(903) 570-0602

Taxonomy

Speciality
Code
Description
License number
State
2083S0010X
Sports Medicine (Preventive Medicine) Physician
Primary
120402065-AT2240
TX

Other

Enumeration date
01/21/2019
Last updated
01/21/2019
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