Kathy Tyler Gibson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15153 Issued in TX

Practice address

4430 Harrisburg Blvd
Houston, TX 77011

Phone

(713) 644-9209

Fax

(713) 644-7824

NPI assigned

Jul 1, 2005

Last updated

Apr 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kathy T. Gibson DDS

  • General Practice Dentistry
  • Houston, TX
  • NPI 1396290854
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1417954702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 N HAYWOOD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770611510",
            "telephone_number": "713-644-9209",
            "fax_number": "713-644-7824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4430 HARRISBURG BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77011",
            "telephone_number": "713-644-9209",
            "fax_number": "713-644-7824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "KATHY",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-01",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "15153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111256701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald M. Gibson, M.D.
• Gordon R Gibson Jr., D.D.S.
• Heather Marie Gibson, PA-C
• Jennifer Gibson
• Katherine Gibson
• Kendra Gibson
• Larry Hiriam Gibson Jr.
• Lauren Gibson, M.D.
• Lesley Davis Gibson, M.D.
• Linda Ann Gibson, RN, MSN, ANP-C

• General Practice Dentistry in Houston, TX
• Providers in Houston, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.