Provider Demographics
NPI:1558382473
Name:GAMIL, WAFER S (MD)
Entity Type:Individual
Prefix:
First Name:WAFER
Middle Name:S
Last Name:GAMIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6505 W PARK BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6212
Mailing Address - Country:US
Mailing Address - Phone:469-682-5218
Mailing Address - Fax:972-408-0716
Practice Address - Street 1:6505 W PARK BLVD STE 306
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6212
Practice Address - Country:US
Practice Address - Phone:469-682-5218
Practice Address - Fax:972-408-0716
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5942207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX104126106Medicaid
TX104126107Medicaid
TX104126105Medicaid
TX8C6420Medicare ID - Type Unspecified
TX8C6638Medicare ID - Type Unspecified
TX8B7346Medicare ID - Type Unspecified
TX104126107Medicaid
TX104126106Medicaid
TX8L5232Medicare PIN