Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | K9284 | TX |
Y | 208600000X | Surgeon | K9284 | TX |
N | 2086S0102X | Surgical Critical Care | K9284 | TX |
NPI | 1346279502 |
---|---|
Provider Name | Brijesh S Gill |
First Address | Dallas, TX 75303-1173 |
Second Address | Tyler, TX 75701-2036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2006 |
Last Update Date | 09/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
158241301 | (05) | TX |
158241307 | (05) | TX |
1L0846 | MEDICARE (01) | VA |
8F6695 | BCBS (01) | TX |
H83624 | (02) | TX |