Organization
SHANE GILLIAM, M.D., P.A.
Active
Other names
Family Medicine Associates of Stephenville
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE SHANE GILLIAM M.D. (PHYSICIAN/OWNER)
(254) 965-8760
Entity
Organization
Contact information
Practice address
630 N GRAHAM STREET, STEPHENVILLE, TX 76401-3552
(254) 965-8760
(254) 965-8766
Mailing address
630 N GRAHAM STREET, STEPHENVILLE, TX 76401-3552
(254) 965-8760
(254) 965-8766
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
L7278
TX
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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