Provider Demographics
NPI:1477218725
Name:ALEXANDRIA R. GIBBS DDS PLLC
Entity Type:Organization
Organization Name:ALEXANDRIA R. GIBBS DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-776-7266
Mailing Address - Street 1:11309 BANDERA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-2602
Mailing Address - Country:US
Mailing Address - Phone:210-776-7266
Mailing Address - Fax:210-701-8995
Practice Address - Street 1:11309 BANDERA RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-2602
Practice Address - Country:US
Practice Address - Phone:210-776-7266
Practice Address - Fax:210-701-8995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty