Provider Demographics
NPI:1063633709
Name:GILBERT, CAROL F
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:F
Last Name:GILBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 AUDUBON PL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-4413
Mailing Address - Country:US
Mailing Address - Phone:713-527-8002
Mailing Address - Fax:713-662-0038
Practice Address - Street 1:3509 AUDUBON PL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-4413
Practice Address - Country:US
Practice Address - Phone:713-527-8002
Practice Address - Fax:713-662-0038
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX040001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS40DOtherBLUE CROSS ID NUMBER