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NPI Code Detail

MEDICARE: DR. KRISTIN GILILLAND PHARMD

MEDICARE: DR. KRISTIN GILILLAND PHARMD
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
11835P2201XAmbulatory Care Pharmacist54829TX
21835X0200XOncology Pharmacist54829TX
31835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist54829TX
4183500000XPharmacist54829TX

General Provider Information

NPI Number : 1972862340
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTIN GILILLAND PHARMD
Provider Business Mailing Address
First Line : 1400 8TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4110
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1450 8TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4110
Country : US
Telephone Number : 817-702-8300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2012
Last Update Date : 09/13/2024

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