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NPI Code Detail

MEDICARE: DR. JAMES T. GILLEY M.D.

MEDICARE:  DR. JAMES T. GILLEY  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
1207R00000XInternal Medicine PhysicianJ7398TX

General Provider Information

NPI Number : 1770506768
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES T. GILLEY M.D.
Provider Business Mailing Address
First Line : PO BOX 5839
Second Line :
City : WACO
State : TX
Zip : 76708-0839
Country : US
Telephone Number : 254-202-6546
Fax Number : 254-202-6541
Provider Business Practice Location Address
First Line : 3000 HERRING AVE
Second Line :
City : WACO
State : TX
Zip : 76708-3239
Country : US
Telephone Number : 254-202-6546
Fax Number : 254-202-6541
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JAMES T. GILLEY M.D.” Practice Location

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