Reef Royal Gillum, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

J8248 Issued in TX

Practice address

612 E Dallas Rd
Suite 300
Grapevine, TX 76051

Phone

(972) 552-5599

Fax

(972) 552-5598

NPI assigned

Feb 3, 2010

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• W PA Onsiterx

  • Pharmacist
  • Harmony, PA
  • NPI 1053640821
  NPD (past)

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1962734764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751260190",
            "telephone_number": "972-552-5599",
            "fax_number": "972-552-5598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 E DALLAS RD",
            "address_2": "SUITE 300",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "76051",
            "telephone_number": "972-552-5599",
            "fax_number": "972-552-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLUM",
        "first_name": "REEF",
        "middle_name": "ROYAL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-03",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "J8248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faryal Abdul Ghaffar, MD
• Fred Elias Ghali, MD
• Dana Giacalone, DPM
• Gloria Kay Gibson
• Morgan Gibson, OTD, OTR/L
• Elizabeth Gitau
• Glade Crossing Dental, PA
• Glaucoma Specialists of Texas SHP PA
• Shelby Leigh Gnepper, ASA
• Abigail Irene Salomon Gold, LPC

• Surgery Physician in Grapevine, TX
• Providers in Grapevine, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.

Verify at the official NPI Registry.