Individual
ROBERT MILTON GILLIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4406 N LAURENT ST, VICTORIA, TX 77901-2742
(361) 578-0107
(361) 578-1320
Mailing address
4406 N LAURENT ST, VICTORIA, TX 77901-2742
(361) 578-0107
(361) 578-1320
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
E2574
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0880170001
CIGNA GOVERNMENT SUPPLIER NUMBER
TX
05
—
098147402
—
TX
Enumeration date
06/13/2006
Last updated
08/28/2008
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