Provider Demographics
NPI:1467846931
Name:GIBSON, SARAH (OD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:GIBSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3313 RR 620 S STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-6871
Mailing Address - Country:US
Mailing Address - Phone:512-263-3550
Mailing Address - Fax:
Practice Address - Street 1:3313 RANCH ROAD 620 S
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-6870
Practice Address - Country:US
Practice Address - Phone:512-263-3550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-23
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7839152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist