Provider Demographics
NPI:1912074162
Name:GILLIAM, FRANK G JR (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:G
Last Name:GILLIAM
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2102 TREASURE HILLS BLVD # 3.144
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8736
Mailing Address - Country:US
Mailing Address - Phone:956-296-1998
Mailing Address - Fax:956-296-6851
Practice Address - Street 1:2902 HAINE DRIVE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550
Practice Address - Country:US
Practice Address - Phone:956-296-4000
Practice Address - Fax:956-296-2842
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY234837-12084N0400X
KY293112084N0400X
PAMD4367242084N0400X
TXS72212084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH08ND70401OtherBCBS
TX4145484-01Medicaid
NYE75686Medicare UPIN