MEDICARE: DR. ADANA MILLIKEN GIPSON

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	208000000X	Pediatrics Physician	J6458	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578638896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADANA MILLIKEN GIPSON

Provider Business Mailing Address
First Line	:	3000 N IH 35 STE 770
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78705-1853
Country	:	US
Telephone Number	:	512-482-8880
Fax Number	:	512-482-8862

Provider Business Practice Location Address
First Line	:	12221 N MOPAC EXPY
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-2401
Country	:	US
Telephone Number	:	512-482-8880
Fax Number	:

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	02/04/2026

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