MEDICARE: DR. MAX GILOT DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	1238873	TX

General Provider Information

NPI Number	:	1316306665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAX GILOT DPT

Provider Business Mailing Address
First Line	:	2629 PARADISE ST
Second Line	:
City	:	VERNON
State	:	TX
Zip	:	76384-5226
Country	:	US
Telephone Number	:	940-782-2219
Fax Number	:

Provider Business Practice Location Address
First Line	:	2629 PARADISE ST
Second Line	:
City	:	VERNON
State	:	TX
Zip	:	76384-5226
Country	:	US
Telephone Number	:	940-782-2219
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2016
Last Update Date	:	02/15/2016

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Directions to “ DR. MAX GILOT DPT” Practice Location

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