Provider Demographics
NPI:1447509823
Name:GIBSON, ALLYSON C (ACNP)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:C
Last Name:GIBSON
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:ALLYSON
Other - Middle Name:C
Other - Last Name:DOOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACNP
Mailing Address - Street 1:4515 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-5810
Mailing Address - Country:US
Mailing Address - Phone:830-456-9212
Mailing Address - Fax:
Practice Address - Street 1:6560 FANNIN ST STE 2206
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2726
Practice Address - Country:US
Practice Address - Phone:713-790-4615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP122265 / RN 755449363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX304921503Medicaid
TX304921503Medicaid