Active NPI
Michael P Gilliland, MD
- Specialist
- Lake Jackson, TX
National Provider Identifier
1376538249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- F3997
- Practice address
- 215 Oak Dr S
Suite D
Lake Jackson, TX 77566-5629 - Phone
- (979) 297-2755
- Fax
- (979) 297-9737
- NPI assigned
- Sep 15, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | F3997 | TX | Primary |
Addresses
Primary practice location
215 Oak Dr S
Suite D
Lake Jackson, TX 77566-5629
Mailing address
215 Oak Drive S
Suite D
Lake Jackson, TX 77566
Phone (979) 297-2755
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 097351301 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F3997 | TX | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279670400000",
"number": "1376538249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 OAK DRIVE S",
"address_2": "SUITE D",
"city": "LAKE JACKSON",
"state": "TX",
"postal_code": "77566",
"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",
"address_2": "SUITE D",
"city": "LAKE JACKSON",
"state": "TX",
"postal_code": "775665629",
"telephone_number": "979-297-2755",
"fax_number": "979-297-9737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLILAND",
"first_name": "MICHAEL",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-15",
"last_updated": "2010-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TX",
"license": "F3997",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "097351301",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Jackson, TX
- Gateway Consulting and Psychological Services
- Genesis Geriatriccare and Consulting Services
- Claudia Esther Gernand, IBCLC
- Giles Surgical Assisting, LLC
- Jason M Giles, CSFA, LSA
- Kavitha Ginjupalli, D.D.S
- Judith Gold, MD
- Corby Weldon Gotcher, D.D.S.
- Jeevan Chaythan Gowda, MD
- Jonathan Patrick Grady, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.