Look up the most recent NPI and PECOS records

Michael David Gilly

Anesthesiology

Allopathic & Osteopathic Physicians

12222 Merit Dr Ste 600, Dallas, TX 75251-3294

(972) 715-5000 (972) 233-1999

PECOS Enrollment

This provider is enrolled in PECOS as MICHAEL GILLY.

Based on the most recent information from CMS, provider Michael David Gilly is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1215164462
Provider Type
Individual
Full Name
Gilly, Michael David
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
6/15/2009
Last Updated
6/14/2022

Contact Information

Practice Location

12222 Merit Dr Ste 600, Dallas, TX 75251-3294

(972) 715-5000

(972) 715-9976

Mailing Location

PO Box 840853, Dallas, TX 75284-0853

(972) 233-1999

(972) 233-3666

Provider Taxonomies

Code	Description	License
Code 207L00000X Primary	Description Anesthesiology Allopathic & Osteopathic Physicians	License P1548 Texas
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Michael David Gilly

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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