| NPI | 1093005704 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2011-04-14 |
| Last Updated | 2019-10-23 |
| Mailing Address | 4921 Long Prairie Rd, Suite 100 Flower Mound, TX 75028-2716 United States Phone: (972) 691-8700 | Fax: (972) 691-8782 📍 View Map |
| Primary Practice Address | 4921 Long Prairie Rd, Suite 100 Flower Mound, TX 75028-2716 United States Phone: (972) 691-8700 | Fax: (972) 691-8782 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | TX | 340101001 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 390200000X – Student in an Organized Health Care Education/Training Program | - | - |
| Yes | 207Q00000X – Family Medicine | TX | P8476 |
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About NPI 1093005704
Megan Dianne Gillem D.O. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1093005704. The primary specialty listed is Family Medicine. The provider is located in Flower Mound, TX. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2011-04-14. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1093005704?
NPI 1093005704 belongs to Megan Dianne Gillem D.O., a Family Medicine in Flower Mound, TX. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1093005704 active?
The current status of NPI 1093005704 in the NPPES registry is Active. The record was last updated on 2019-10-23.
What specialty is NPI 1093005704?
NPI 1093005704 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1093005704?
You can verify NPI 1093005704 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1093005704?
The primary practice address on file for NPI 1093005704 is 4921 Long Prairie Rd, Flower Mound, TX 75028-2716. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1093005704 issued?
NPI 1093005704 was first issued (enumerated) on 2011-04-14. The NPPES record was last updated on 2019-10-23.
Practice Location Map
Megan Dianne Gillem is located at 4921 Long Prairie Rd, Flower Mound, TX. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Megan Dianne Gillem. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1093005704. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Family Medicine | P8476 | TX |