Active NPI
Michael Gilliam
- Hearing Instrument Specialist
- Texarkana, TX
National Provider Identifier
1598923658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 50382
- Practice address
- 1315 Walnut St
Texarkana, TX 75501-4446 - Phone
- (903) 794-3767
- Fax
- (903) 794-3493
- NPI assigned
- May 27, 2008
- Last updated
- May 27, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 50382 | TX | Primary |
Addresses
Primary practice location
1315 Walnut St
Texarkana, TX 75501-4446
Mailing address
400 S Henderson St
Fort Worth, TX 76104-1017
Phone (817) 335-2583
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50382 | TX | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211846400000",
"number": "1598923658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 S HENDERSON ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761041017",
"telephone_number": "817-335-2583",
"fax_number": "817-335-2597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 WALNUT ST",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755014446",
"telephone_number": "903-794-3767",
"fax_number": "903-794-3493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIAM",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-27",
"last_updated": "2008-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "TX",
"license": "50382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.