MEDICARE: DANIEL GILADA M.D.

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	207R00000X	Internal Medicine Physician	BP10047258	TX
2	207RC0000X	Cardiovascular Disease Physician	S1814	TX
3	207RC0000X	Cardiovascular Disease Physician	BP10047258	TX

General Provider Information

NPI Number	:	1700222486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL GILADA M.D.

Provider Business Mailing Address
First Line	:	4421 LONG PRAIRIE RD STE 200
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-1752
Country	:	US
Telephone Number	:	469-800-1030
Fax Number	:

Provider Business Practice Location Address
First Line	:	4421 LONG PRAIRIE RD STE 200
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-1752
Country	:	US
Telephone Number	:	469-800-1030
Fax Number	:

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

Provider Enumeration Date	:	05/21/2013
Last Update Date	:	09/14/2022

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