Provider Demographics
NPI:1003261736
Name:GIBUNE, DEEBORR MBISSINE (DC)
Entity Type:Individual
Prefix:DR
First Name:DEEBORR
Middle Name:MBISSINE
Last Name:GIBUNE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DEEBORR
Other - Middle Name:MBISSINE
Other - Last Name:NDENN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:255 S DENTON TAP RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5050
Mailing Address - Country:US
Mailing Address - Phone:972-556-9595
Mailing Address - Fax:
Practice Address - Street 1:255 S DENTON TAP RD
Practice Address - Street 2:SUITE 200
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-5050
Practice Address - Country:US
Practice Address - Phone:972-556-9595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12395111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor