Provider Demographics
NPI:1326397928
Name:GILLMAN, DANA (CD, ICCE, IBCLC, RLC)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:
Last Name:GILLMAN
Suffix:
Gender:F
Credentials:CD, ICCE, IBCLC, RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17810 SEVEN PINES DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-4130
Mailing Address - Country:US
Mailing Address - Phone:713-962-2447
Mailing Address - Fax:
Practice Address - Street 1:12777 JONES RD STE 455
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4950
Practice Address - Country:US
Practice Address - Phone:281-305-0411
Practice Address - Fax:281-572-0627
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
TXL-46570174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula