Provider Demographics
NPI:1689948309
Name:GIBBS, ALEXANDRA ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:ELIZABETH
Last Name:GIBBS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 ROSEBAY RD
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2247
Mailing Address - Country:US
Mailing Address - Phone:409-673-6060
Mailing Address - Fax:
Practice Address - Street 1:12605 EAST FWY STE 212
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-5619
Practice Address - Country:US
Practice Address - Phone:713-453-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1207311225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist