Provider Demographics
NPI:1508925876
Name:GIPSON, HELEN D (DPM)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:D
Last Name:GIPSON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 A EAST CAMP WISDOM RD
Mailing Address - Street 2:SUITE 296
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116
Mailing Address - Country:US
Mailing Address - Phone:972-740-2957
Mailing Address - Fax:
Practice Address - Street 1:217 A EAST CAMP WISDOM RD
Practice Address - Street 2:SUITE 296
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116
Practice Address - Country:US
Practice Address - Phone:972-740-2957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0964213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT13455Medicare UPIN
TX00JD54Medicare ID - Type Unspecified