DEIDRE BIBB


Address: 1814 Roseland Blvd Ste 100, Tyler, TX 75701-4262
Phone: 9035253300

DEIDRE BIBB (NPI# 1891269056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1891269056
Entity Type Individual
Full Name DEIDRE BIBB
Practice Address 1814 Roseland Blvd Ste 100
Tyler
TX 75701-4262
Mailing Address 102 S Stewart St
White Oak
TX 75693-1514
Practice Telephone 9035253300
Mailing Telephone 9035700602
Enumeration Date 2019-01-21
Last Update Date 2019-01-21
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2083S0010X Preventive Medicine
Specialization: Sports Medicine
120402065-AT2240 TX Allopathic & Osteopathic Physicians

Office Location

Street Address 1814 ROSELAND BLVD STE 100
City TYLER
State TX
Zip Code 75701-4262

Providers in the same location

NPI Name Taxonomy Address Enumeration
1033691324 Karley Ann Ritchie Physical Therapy Assistant 1814 Roseland Blvd Ste 100, Tyler, TX 75701-4262 2018-09-03

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1962057059 Gonzalo Fernandez Physical Therapy Assistant 753 S Beckham Ave, Tyler, TX 75701 2019-08-06
1215422654 Adrianna Bussell Nurse Practitioner 1000 South Beckham, Tyler, TX 75701 2018-06-28
1285128017 Idowu Akintokunbo Akinyele Dentist Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 2018-06-15
1992208912 Heather Renee Vancleave Occupational Therapy Assistant 1228 Louann Lane, Tyler, TX 75701 2018-03-15
1497260533 Smile Workshop Mckinney, Pllc Dentist 301 N. Custer Rd, Mckinney, TX 75701 2017-12-12
1396266441 Eye Surgery Center of East Texas, Pllc Clinic/Center 2448 E 5th St, Tyler, TX 75701 2017-06-29
1962936369 Collins Complete Family Care Nurse Practitioner 1910 E Se Loop 323 # 176, Tyler, TX 75701 2017-04-12
1386187052 Fellowship Health Team LLC Home Health 1124 S Fleishel Ave, Tyler, TX 75701 2016-11-29
1205382454 Brenton Robinson Nurse Practitioner 1100 East Lake St, 160, Tyler, TX 75701 2016-08-28
1851846208 Care First Pharmacy, LLC Pharmacy 1910 Roseland Blvd A, Tyler, TX 75701 2016-08-15
Find all providers in zip 75701

Taxonomy Information

Taxonomy Code 2083S0010X
Grouping Allopathic & Osteopathic Physicians
Classification Preventive Medicine
Specialization Sports Medicine

Taxonomy Definition

A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Preventive Medicine.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1811506538 Regenerate Atx Pllc Preventive Medicine 11610 Fm 2244 Rd Ste 230, Austin, TX 78738-5457 2020-07-28
1063057602 Heather Penka Preventive Medicine 820 Holiday Ln, North Richland Hills, TX 76180 2019-11-07
1588030241 Texas A&m University Preventive Medicine 12 John David Crow Blvd, College Station, TX 77843 2015-08-18
1952378556 David B. Tsai, M.d., P.a. Preventive Medicine 210 Barton Springs Rd, Suite 200, Austin, TX 78704-1254 2006-03-02
1013526201 Kimberly Moore Preventive Medicine 1333 W Washington St, Stephenville, TX 76401-4168 2020-07-24
1104382936 Ashley Christine Wagner Preventive Medicine 3724 Executive Center Dr Ste G10, Austin, TX 78731-1665 2019-02-18
1891169686 Tracy Coleman IIi Preventive Medicine 6000 Eldorado Pkwy, Apt# 222, Frisco, TX 75033-3573 2015-11-17

Competitor

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City TYLER
Zip Code 75701

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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