MEDICARE: DR. GARY RAY PILLERS D.D.S, F.A.G.D

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	1223G0001X	General Practice Dentistry	11924	TX

General Provider Information

NPI Number	:	1659373918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY RAY PILLERS D.D.S, F.A.G.D

Provider Business Mailing Address
First Line	:	17515 SPRING CYPRESS RD
Second Line	:	STE I
City	:	CYPRESS
State	:	TX
Zip	:	77429-2689
Country	:	US
Telephone Number	:	281-304-4280
Fax Number	:	281-304-4286

Provider Business Practice Location Address
First Line	:	17515 SPRING CYPRESS RD
Second Line	:	STE I
City	:	CYPRESS
State	:	TX
Zip	:	77429-2689
Country	:	US
Telephone Number	:	281-304-4280
Fax Number	:	281-304-4286

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	07/08/2007

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