MEDICARE: AMARDEEP K GILL NP

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	163WP0000X	Pain Management Registered Nurse	664977	TX

General Provider Information

NPI Number	:	1013255926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMARDEEP K GILL NP

Provider Business Mailing Address
First Line	:	8230 WALNUT HILL LN
Second Line	:	STE 320
City	:	DALLAS
State	:	TX
Zip	:	75231-4482
Country	:	US
Telephone Number	:	214-265-9991
Fax Number	:	214-265-1457

Provider Business Practice Location Address
First Line	:	8230 WALNUT HILL LN
Second Line	:	STE 320
City	:	DALLAS
State	:	TX
Zip	:	75231-4482
Country	:	US
Telephone Number	:	214-265-9991
Fax Number	:	214-265-1457

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

Provider Enumeration Date	:	01/28/2013
Last Update Date	:	01/28/2013

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