Provider Demographics
NPI:1659774149
Name:ANITA ARORA GILL, MD PLLC
Entity Type:Organization
Organization Name:ANITA ARORA GILL, MD PLLC
Other - Org Name:GILL DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-760-3373
Mailing Address - Street 1:PO BOX 9058
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77387-9058
Mailing Address - Country:US
Mailing Address - Phone:936-760-3373
Mailing Address - Fax:936-760-3374
Practice Address - Street 1:1501 RIVER POINTE DR
Practice Address - Street 2:SUITE 140
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2656
Practice Address - Country:US
Practice Address - Phone:936-760-3373
Practice Address - Fax:936-760-3374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-29
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3870207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX379738Medicare PIN