Provider Demographics
NPI:1083626154
Name:GIBBS, PAUL STEPHEN (RPH)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:STEPHEN
Last Name:GIBBS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:31020 WOODBINE WAY
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS RANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78015
Mailing Address - Country:US
Mailing Address - Phone:830-388-0399
Mailing Address - Fax:210-764-1038
Practice Address - Street 1:3603 PAESANOS PKWY STE 102
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231
Practice Address - Country:US
Practice Address - Phone:210-448-9080
Practice Address - Fax:210-764-1038
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX33779183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist