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General NPI Number Information
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NPI Number | 1447313127
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Entity Type | Organization
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Legal Business Name | SHAZIA GILL, MD, PA
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 100 MEDICAL CENTER BLVD. SUITE 200
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City | CONROE
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State | TX
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Zip | 77304-2821
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Country | US
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Telephone | 936-441-9680
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Fax |
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Provider Business Mailing Address
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Address Line | 100 MEDICAL CENTER BLVD. SUITE 200
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City | CONROE
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State | TX
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Zip | 77304-2821
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Country | US
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Telephone | 936-441-9680
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAZIA GILL
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Credential | MD
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Telephone | 936-441-9680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | M4093
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License Number State | TX
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