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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 18 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 1467421669 NPPES
Missouri MEDICAID 1467421669
Missouri Other 431560263

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