Provider Demographics
NPI:1407412034
Name:GILL, SUNAINA SHALU (STA)
Entity Type:Individual
Prefix:
First Name:SUNAINA
Middle Name:SHALU
Last Name:GILL
Suffix:
Gender:F
Credentials:STA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 N BUCKNER BLVD STE 312
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-2720
Mailing Address - Country:US
Mailing Address - Phone:214-324-1900
Mailing Address - Fax:
Practice Address - Street 1:718 NORTH BUCKNER BOULEVARD
Practice Address - Street 2:#312
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218
Practice Address - Country:US
Practice Address - Phone:214-324-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX403952355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant