MEDICARE: DR. NICOLE CHERISE GILLMAN 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	207V00000X	Obstetrics & Gynecology Physician	N1647	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1902870140	OTHER	VA	VIRGINIA PREMIER HEALTH PLAN
2	1902870140	OTHER	VA	COVENTRY HEALTH NETWORK
3	1902870140	OTHER	VA	UNITED HEALTHCARE
4	PAR	OTHER	VA	CORVEL
5	PAR	OTHER	VA	MULTIPLAN
6	PAR	OTHER	VA	AETNA
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	PAR	OTHER	VA	VIRGINIA HEALTH NETWORK
9	10104075	OTHER	VA	OPTIMA HEALTH
10	PAR	OTHER	VA	USA MANAGED CARE
11	-027	OTHER	VA	TRICARE/CHAMPUS
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	486316	OTHER	VA	ANTHEM BC/BS

General Provider Information

NPI Number	:	1902870140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLE CHERISE GILLMAN M.D.

Provider Business Mailing Address
First Line	:	6410 FANNIN ST STE 350
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-3004
Country	:	US
Telephone Number	:	832-325-7131
Fax Number	:	713-511-2216

Provider Business Practice Location Address
First Line	:	6410 FANNIN ST STE 350
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-3004
Country	:	US
Telephone Number	:	832-325-7131
Fax Number	:	713-511-2216

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	11/25/2020

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