Provider Demographics
NPI:1669019758
Name:GIBSON, BIANCA TENE
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:TENE
Last Name:GIBSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19780 ATASCOCITA SHORES DR APT 1032
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2935
Mailing Address - Country:US
Mailing Address - Phone:770-695-8329
Mailing Address - Fax:
Practice Address - Street 1:3918 ATASCOCITA RD APT 435
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-4458
Practice Address - Country:US
Practice Address - Phone:770-695-8329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-08
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management