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General NPI Number Information
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NPI Number | 1588935332
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Entity Type | Individual
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Provider Name | GREGORY PAUL GILL CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/25/2012
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 3551 ROGER BROOKE DR
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City | SAN ANTONIO
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 210-916-4141
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 841656
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City | DALLAS
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State | TX
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Zip | 75284-1656
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Country | US
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Telephone | 903-531-5000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 717697
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP121346
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License Number State | TX
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