Tristan Lyn Gilliam, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

115431 Issued in TX

Practice address

5855 Milton St
Dallas, TX 75206-4202

Phone

(694) 310-1700

Fax

(469) 310-1701

NPI assigned

Jan 23, 2017

Last updated

Dec 10, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1851838312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 ELDORADO PKWY # 102-20",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750706510",
            "telephone_number": "469-310-1700",
            "fax_number": "469-310-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 MILTON ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752064202",
            "telephone_number": "694-310-1700",
            "fax_number": "469-310-1701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5555 Arapaho Rd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752483442",
            "country_code": "US",
            "telephone_number": "469-620-4260",
            "fax_number": "469-620-4261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "TRISTAN",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "115431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arve Ward Gillette, M.D.
• Elisha Gilley, LMSW
• Elizabeth Gilley
• Gilley's Pharmacy, Inc
• Penny Gilliam, CRNA
• Vanessa Gilliam, M.ED., BCBA, LBA
• Derrick Lynn Gillians, RRT
• Mark H. Gillie, M.D.
• George R Gilligan, M.D.
• Connor Gilliland

• Occupational Therapist in Dallas, TX
• Providers in Dallas, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.