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Individual

PAULA HARRISON GILLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
12221 MERIT DR, SUITE 1610, DALLAS, TX 75251-2202
(972) 372-0912
(214) 217-1901
Mailing address
3500 GASTON AVE, 4 ROBERTS, DALLAS, TX 75246-2017
(214) 820-3000

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
521941
TX
363LG0600X
Gerontology Nurse Practitioner
521941
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
081425302
MEDICAID GROUP
TX
05
1409021-06
TX
05
140902103
TX
05
140902104
TX
05
140902105
TX
05
140902106
TX
01
P00256840
RR MEDICARE
TX
Enumeration date
08/21/2006
Last updated
10/10/2012
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