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NPI Code Detail

MEDICARE: DR. JASON WESLEY GILLMAN MD

MEDICARE: DR. JASON WESLEY GILLMAN MD
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
1207RI0200XInfectious Disease PhysicianN4429TX

General Provider Information

NPI Number : 1427219690
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON WESLEY GILLMAN MD
Provider Business Mailing Address
First Line : 1717 MAIN ST STE 5850
Second Line :
City : DALLAS
State : TX
Zip : 75201-7317
Country : US
Telephone Number : 972-449-0540
Fax Number :
Provider Business Practice Location Address
First Line : 1717 MAIN ST STE 5850
Second Line :
City : DALLAS
State : TX
Zip : 75201-7317
Country : US
Telephone Number : 972-449-0540
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2008
Last Update Date : 05/20/2024

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