Provider Demographics
NPI:1619206414
Name:KNAPP-GIBSON, MARTA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARTA
Middle Name:
Last Name:KNAPP-GIBSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 FM 3009
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-1132
Mailing Address - Country:US
Mailing Address - Phone:210-566-2477
Mailing Address - Fax:
Practice Address - Street 1:3801 FM 3009
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1132
Practice Address - Country:US
Practice Address - Phone:210-566-2477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist