Provider Demographics
NPI:1003997099
Name:GIBBONS, JANICE LYNN (MD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:LYNN
Last Name:GIBBONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3150 CLARKSVILLE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-8076
Mailing Address - Country:US
Mailing Address - Phone:903-782-9206
Mailing Address - Fax:903-783-7367
Practice Address - Street 1:3150 CLARKSVILLE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-8076
Practice Address - Country:US
Practice Address - Phone:903-782-9206
Practice Address - Fax:903-783-7367
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP1866208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics