Tilley, Gary L

Tilley, Gary L is an individual health care provider with primary practice located at 1115 Avenue G , Bay City TX 77414-3540. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Tilley, Gary L can be contacted via phone (979) 245-6783.

Contact Information

Primary practice address
1115 Avenue G Bay City TX 77414-3540
Phone: (979) 245-6783
Fax: (979) 241-6783
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 441807 Texas

Profile Details

NPI number 1851320196
LBN Legal business name Tilley, Gary L
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2006
Last updated Jul 8th, 2007 - about 19 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 1851320196 NPPES
Texas Other C-80B BC-BS
Texas MEDICAID C087543C5 BC-BS

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