Provider Demographics
NPI:1669456414
Name:GILL, NAVNEET K (MD)
Entity Type:Individual
Prefix:
First Name:NAVNEET
Middle Name:K
Last Name:GILL
Suffix:
Gender:F
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:PO BOX 732973
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-2973
Mailing Address - Country:US
Mailing Address - Phone:817-702-8450
Mailing Address - Fax:
Practice Address - Street 1:3200 W EULESS BLVD
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-6253
Practice Address - Country:US
Practice Address - Phone:817-702-1100
Practice Address - Fax:817-702-6493
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7394207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8X7294OtherBCBS
TXP00421823OtherRAILROAD MEDICARE
TX164609313Medicaid
TX8X7294OtherBCBS
TXH99243Medicare UPIN