Provider Demographics
NPI:1326878521
Name:GILL, MAGDA CECILIA
Entity type:Individual
Prefix:MRS
First Name:MAGDA
Middle Name:CECILIA
Last Name:GILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2322 DIAMOND OAKS DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-7314
Mailing Address - Country:US
Mailing Address - Phone:469-226-7012
Mailing Address - Fax:
Practice Address - Street 1:3409 SPECTRUM BLVD STE 300
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-9713
Practice Address - Country:US
Practice Address - Phone:972-231-6564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1170434363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily