Provider Demographics
NPI:1376066100
Name:GIBBS, ALEXANDRIA (DDS)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:GIBBS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11309 BANDERA RD
Mailing Address - Street 2:STE.101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250
Mailing Address - Country:US
Mailing Address - Phone:210-776-7266
Mailing Address - Fax:210-701-8995
Practice Address - Street 1:11309 BANDERA RD
Practice Address - Street 2:STE.101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250
Practice Address - Country:US
Practice Address - Phone:210-776-7266
Practice Address - Fax:210-701-8995
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX331161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice