Gillian V. Kwi, D.D.S.
Individual provider Active NPI Dentist · Port Lavaca, TX
NPI 1982844940 · NPPES record last updated Mar 3, 2009
Key facts
- NPI
- 1982844940
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 16069 (TX)
- Practice address
- 1112 Half League Rd
Port Lavaca, TX 77979 - Phone
- (361) 552-6916
- Fax
- (361) 552-6916
- NPI assigned
- Mar 3, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 16069 | TX | Yes |
Addresses
Primary practice location
1112 Half League Rd
Port Lavaca, TX 77979
Mailing address
1112 Half League Rd
Port Lavaca, TX 77979
Phone (361) 552-6916
Other providers in Port Lavaca, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.