MEDICARE: HARJINDER GILL P.A.

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	363A00000X	Physician Assistant	PA09517	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	:	1932507050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARJINDER GILL P.A.

Provider Business Mailing Address
First Line	:	20126 REDONDO VALLEY DR
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-6344
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2615 SOUTHWEST FWY STE 290
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-4611
Country	:	US
Telephone Number	:	713-523-8800
Fax Number	:

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

Provider Enumeration Date	:	12/06/2014
Last Update Date	:	12/06/2014

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