Gore, Jill M

Gore, Jill M is an individual health care provider with primary practice located at 3551 Roger Brooke Dr , Fort Sam Houston TX 78234-4504. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Gore, Jill M can be contacted via phone (210) 539-9582.

Contact Information

Primary practice address
3551 Roger Brooke Dr Fort Sam Houston TX 78234-4504
Phone: (210) 539-9582
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA04773 Texas
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA04773 Texas

Profile Details

NPI number 1093741332
LBN Legal business name Gore, Jill M
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2006
Last updated Oct 3rd, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093741332 NPPES
Texas Other 8Y0190 BLUECROSS BLUESHIELD TX.

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