Provider Demographics
NPI:1285459909
Name:GILL, BRIAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:GILL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 LINDEN BLVD APT 1C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-3758
Mailing Address - Country:US
Mailing Address - Phone:347-465-1465
Mailing Address - Fax:
Practice Address - Street 1:2306 RAYFORD RD STE 300
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-1707
Practice Address - Country:US
Practice Address - Phone:281-863-9944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1402799225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist