Gibson, Brent Randall
Gibson, Brent Randall is an individual health care provider with primary practice located at 3851 Roger Brooke Dr , Fort Sam Houston TX 78234-4501. He recently has only one registered license in Allopathic & Osteopathic Physicians / Occupational Medicine, which is considered as his primary health care specialty. Gibson, Brent Randall can be contacted via phone (210) 916-2460.Contact Information
Primary practice address
3851 Roger Brooke Dr
Fort Sam Houston TX 78234-4501
Phone: (210) 916-2460
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Occupational Medicine | 2083X0100X | #01056435A | Indiana |
Profile Details
NPI number | 1467421669 |
---|---|
LBN Legal business name | Gibson, Brent Randall |
Credentials | MD, MPH |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 17th, 2006 |
Last updated | Oct 28th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1467421669 | NPPES |
Missouri | MEDICAID | 1467421669 | |
Missouri | Other | 431560263 |
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