Provider Demographics
NPI:1952467078
Name:CIBLEY, LAURENCE JAY
Entity Type:Individual
Prefix:
First Name:LAURENCE
Middle Name:JAY
Last Name:CIBLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10470 VISTA DEL SOL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7948
Mailing Address - Country:US
Mailing Address - Phone:915-595-1212
Mailing Address - Fax:915-595-3836
Practice Address - Street 1:10470 VISTA DEL SOL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7948
Practice Address - Country:US
Practice Address - Phone:915-595-1212
Practice Address - Fax:915-595-3836
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1398207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology