Gibson, Bernard R

Gibson, Bernard R is an individual health care provider with primary practice located at 301 University Blvd Mail Route 783, Galveston TX 77555-0783. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Gibson, Bernard R can be contacted via phone (409) 772-1911.

Contact Information

Primary practice address
301 University Blvd Mail Route 783 Galveston TX 77555-0783
Phone: (409) 772-1911
Fax: (409) 772-1943
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X E1590 Texas
Allopathic & Osteopathic Physicians / Dermatology 207N00000X E1590 Texas

Profile Details

NPI number 1821098724
LBN Legal business name Gibson, Bernard R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Jun 9th, 2021 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821098724 NPPES
Texas MEDICAID 1356822357
Texas MEDICAID 167459001
Texas MEDICAID 1674590-04
Texas MEDICAID 1674590-05

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