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Individual

DR. JEFF RAY GIBSON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
F2677
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
807517
BLUE SHIELD
TX
Enumeration date
03/25/2006
Last updated
04/09/2020
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