Individual
DR. MICHAEL P GILLILAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 OAK DR S, SUITE D, LAKE JACKSON, TX 77566-5629
(979) 297-2755
(979) 297-9737
Mailing address
215 OAK DRIVE S, SUITE D, LAKE JACKSON, TX 77566
(979) 297-2755
(979) 297-9737
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
F3997
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097351301
—
TX
Enumeration date
09/15/2005
Last updated
07/21/2010
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