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Individual

DONNA LYNN GILLIAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1761 HIGHWAY 46 W STE 104, NEW BRAUNFELS, TX 78132-4750
(830) 608-1575
(830) 608-0868
Mailing address
1215 E COURT ST, SEGUIN, TX 78155-5129
(830) 303-9400
(830) 303-9420

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA03687
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
218278401
TX
01
H0143584
DPS
TX
01
PA03687
LICENSE
TX
Enumeration date
08/31/2006
Last updated
03/07/2023
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