Doctor Name: | MRS. MIA GIBSON |
NPI Number: | 1457652190 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD,LD,CDE |
License Number: | DT00898 |
Business Practice Address: | 8050 E Hwy 191 Odessa, TX - 797658607 |
Business Phone Number: | 4326402128 |
Business Fax Number: | |
Mailing Address: | 8050 E. Hwy 191, ODESSA |
State: | TX |
Postal Code: | 79760 |
Phone Number: | 4326402128 |
Fax Number: | |
NPI Enumeration Date: | 11/11/2010 |
NPI Last Update Date: | 11/11/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | DT00898 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |