Individual provider Active NPI

Marijan Gillard, MD

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1215044219
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L3658 Issued in TX
Practice address
7330 San Pedro
Ste. 405
San Antonio, TX 78216-6235
Phone
(210) 344-2673
Fax
(210) 344-2649
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L3658 TX Primary

Addresses

Primary practice location

7330 San Pedro
Ste. 405
San Antonio, TX 78216-6235

Mailing address

7330 San Pedro
Ste. 405
San Antonio, TX 78216-6235
Phone (210) 344-2673

Other identifiers 1

IdentifierTypeStateIssuer
174873301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220803003993 TX Order and Referring Only - Family PracticePractitioner - Family Practice 5294706222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Texas, PLLC Family Medicine Past Accepting new patients
Adobe Creek Family Medical Clinic, PA Family Medicine Past Accepting new patients
Wellmed Medical Group, PA Family Medicine Past Accepting new patients
Inpatient Consultants of Texas, PLLC. Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: marijan.gillard@546238333255684.direct.elationemr.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1215044219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7330 SAN PEDRO",
            "address_2": "STE. 405",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166235",
            "telephone_number": "210-344-2673",
            "fax_number": "210-344-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 SAN PEDRO",
            "address_2": "STE. 405",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166235",
            "telephone_number": "210-344-2673",
            "fax_number": "210-344-2649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLARD",
        "first_name": "MARIJAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L3658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174873301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.