Provider Demographics
NPI:1245496876
Name:GIBBS, KIMBERLY BAILEY (MD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:BAILEY
Last Name:GIBBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:CALDWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4330 MEDICAL DR
Mailing Address - Street 2:STE 500
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3342
Mailing Address - Country:US
Mailing Address - Phone:210-576-5306
Mailing Address - Fax:210-694-0645
Practice Address - Street 1:4330 MEDICAL DR
Practice Address - Street 2:STE 500
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3342
Practice Address - Country:US
Practice Address - Phone:210-576-5306
Practice Address - Fax:210-694-0645
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3671207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB156597OtherWELLMED NETWORKS INC
TXB153511OtherWELLMED MEDICAL GROUP PA