Provider Demographics
NPI:1659377299
Name:GIBBONS, KAREN L (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:GIBBONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:LYNN
Other - Last Name:KALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7922 EWING HALSELL DR
Mailing Address - Street 2:SUITE 440
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3726
Mailing Address - Country:US
Mailing Address - Phone:210-614-2500
Mailing Address - Fax:210-614-2755
Practice Address - Street 1:7922 EWING HALSELL DR
Practice Address - Street 2:SUITE 440
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3726
Practice Address - Country:US
Practice Address - Phone:210-614-2500
Practice Address - Fax:210-614-2755
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6959208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics