Michael P. Gilliland, M.D., P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

F3997 Issued in TX

Legal business name

MICHAEL P. GILLILAND, M.D., P.A.

Practice address

215 Oak Dr S Ste D
Lake Jackson, TX 77566-5617

Phone

(979) 297-2755

Fax

(979) 297-9737

NPI assigned

Aug 23, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael P Gilliland, M.D.

Title

President/Owner

Phone

(979) 297-2755

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314057600000",
    "number": "1174803134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 OAK DR S STE D",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665617",
            "telephone_number": "979-297-2755",
            "fax_number": "979-297-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 OAK DR S STE D",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665617",
            "telephone_number": "979-297-2755",
            "fax_number": "979-297-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL P. GILLILAND, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-23",
        "last_updated": "2011-08-23",
        "status": "A",
        "authorized_official_last_name": "GILLILAND",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "979-297-2755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "F3997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "00AG37",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "097351301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.