Provider Demographics
NPI:1962483974
Name:CAHILL, JEFFREY P (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:P
Last Name:CAHILL
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 1:325 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75652-5957
Mailing Address - Country:US
Mailing Address - Phone:903-657-8587
Mailing Address - Fax:903-657-9545
Practice Address - Street 1:325 WILSON ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TX
Practice Address - Zip Code:75652-5957
Practice Address - Country:US
Practice Address - Phone:903-657-8587
Practice Address - Fax:903-657-9545
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9047207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126397202Medicaid
TX126397202Medicaid
TXC14059Medicare UPIN