Provider Demographics
NPI:1336307446
Name:GIBSON, SARA BETH (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:BETH
Last Name:GIBSON
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 1:17198 ST. LUKE'S WAY
Mailing Address - Street 2:SUITE 440
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-8015
Mailing Address - Country:US
Mailing Address - Phone:936-266-2500
Mailing Address - Fax:936-321-4120
Practice Address - Street 1:17198 ST. LUKE'S WAY
Practice Address - Street 2:SUITE 440
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8015
Practice Address - Country:US
Practice Address - Phone:936-266-2500
Practice Address - Fax:936-321-4120
Is Sole Proprietor?:No
Enumeration Date:2008-05-26
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM8673207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB131079Medicare PIN