Basic Information
| Provider Information | |||||||||
| NPI: | 1447313127 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SHAZIA GILL, MD, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 MEDICAL CENTER BLVD. | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CONROE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773042821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9364419680 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 MEDICAL CENTER BLVD. | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CONROE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773042821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9364419680 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GILL | ||||||||
| AuthorizedOfficialFirstName: | SHAZIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9364419680 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | M4093 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.