Leslie Shane Gilliam MD

NPI 1073580916 - Family Medicine - 207Q00000X

NPI Details
NPI 1073580916
Gender Male
Enumeration Date 02/28/2006
Last Updated 06/08/2011
Entity Type Individual
Active Over 10 years ago
Practice Location
630 N GRAHAM ST
STEPHENVILLE TX, 76401-3552, US
Phone (254) 965-8760
Fax (254) 965-8766
Business Location
630 N GRAHAM ST
STEPHENVILLE TX, 76401-3552, US
Phone (254) 965-8760
Fax (254) 965-8766
Toxanomy
Taxonomy Code 207Q00000X
License State Texas
License Number L7278
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According to our database, Leslie Shane Gilliam MD NPI is 1073580916, taxonomy code is 207Q00000X and license number is L7278, license state is located at Texas. Leslie Shane Gilliam MD physically located at 630 N Graham St, Stephenville TX, 76401-3552. NPI Number Leslie Shane Gilliam MD has the Individual type.

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1073580916 NPI number is provided on an as is basis without warranty of any kind. 1073580916 is maintained by the National Plan & Provider Enumeration System. The contents of Leslie Shane Gilliam MD are for informational purposes only.