Provider Demographics
NPI:1740417070
Name:GILBRETH, SHINOBU KISHIGAMI (MD)
Entity Type:Individual
Prefix:
First Name:SHINOBU
Middle Name:KISHIGAMI
Last Name:GILBRETH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHINOBU
Other - Middle Name:
Other - Last Name:KISHIGAMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:18951 MEMORIAL NORTH
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338
Mailing Address - Country:US
Mailing Address - Phone:281-913-4208
Mailing Address - Fax:
Practice Address - Street 1:18951 MEMORIAL NORTH
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338
Practice Address - Country:US
Practice Address - Phone:281-913-4208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5159207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine