Basic Information
Provider Information
NPI: 1417143652
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GILBERT
FirstName: JOY
MiddleName: MARGARET
NamePrefix: MRS.
NameSuffix:  
Credential: OTR
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4601 HARTFORD ST
Address2:  
City: ABILENE
State: TX
PostalCode: 796054603
CountryCode: US
TelephoneNumber: 3257933400
FaxNumber: 3257933587
Practice Location
Address1: 3001 S JACKSON ST
Address2:  
City: SAN ANGELO
State: TX
PostalCode: 769045129
CountryCode: US
TelephoneNumber: 3252236300
FaxNumber: 3252236408
Other Information
ProviderEnumerationDate: 09/21/2007
LastUpdateDate: 09/21/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X104427TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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