Provider Demographics
NPI:1447046206
Name:GIBBS, JACOB BRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:BRIAN
Last Name:GIBBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAKE
Other - Middle Name:BRIAN
Other - Last Name:GIBBS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:20101 LARAMIE DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-1549
Mailing Address - Country:US
Mailing Address - Phone:806-220-9595
Mailing Address - Fax:
Practice Address - Street 1:3601 4TH ST STOP 6211
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-6211
Practice Address - Country:US
Practice Address - Phone:806-787-9836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program