Provider Demographics
NPI:1285926063
Name:ILOFF, GLORIANNA (PA-C)
Entity type:Individual
Prefix:
First Name:GLORIANNA
Middle Name:
Last Name:ILOFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:GLORIANNA
Other - Middle Name:
Other - Last Name:HUNLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:114 SPROLES DR STE 101
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76126-3249
Mailing Address - Country:US
Mailing Address - Phone:817-249-4100
Mailing Address - Fax:
Practice Address - Street 1:114 SPROLES DR STE 101
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76126-3249
Practice Address - Country:US
Practice Address - Phone:817-249-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07296363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant