Provider Demographics
NPI:1629550033
Name:GILL, INDERJIT KAUR
Entity Type:Individual
Prefix:
First Name:INDERJIT
Middle Name:KAUR
Last Name:GILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 HERITAGE PARK DR
Mailing Address - Street 2:
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-4760
Mailing Address - Country:US
Mailing Address - Phone:469-441-6899
Mailing Address - Fax:
Practice Address - Street 1:1525 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-4327
Practice Address - Country:US
Practice Address - Phone:972-496-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1188006225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist