Provider Demographics
NPI:1164712998
Name:GILMORE, MARGARET BROWN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:BROWN
Last Name:GILMORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:100 W DEAN KEETON ST STOP A3900
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78712-1107
Mailing Address - Country:US
Mailing Address - Phone:512-471-4955
Mailing Address - Fax:512-475-9693
Practice Address - Street 1:100 W DEAN KEETON ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712-1091
Practice Address - Country:US
Practice Address - Phone:512-471-4955
Practice Address - Fax:512-475-9693
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0917207Q00000X
TXBP10039550207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX341746101Medicaid
TX341746102Medicaid
TXP01504203Medicare PIN
TX381591YKXVMedicare PIN
TX381591YKXYMedicare PIN