Provider Demographics
NPI:1609836675
Name:GIBBS, WENDY MCKINNEY (PT)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:MCKINNEY
Last Name:GIBBS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:KAY
Other - Last Name:MCKINNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, ATP
Mailing Address - Street 1:38043 WINDY RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77355-5370
Mailing Address - Country:US
Mailing Address - Phone:832-656-7660
Mailing Address - Fax:832-559-7720
Practice Address - Street 1:38043 WINDY RIDGE TRL
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77355-5370
Practice Address - Country:US
Practice Address - Phone:832-656-7660
Practice Address - Fax:832-559-7720
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92969225CA2400X
247200000X
TX1112365225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other