MR. IRA RICHARD GILLUM (NPI# 1528041951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528041951 |
| Entity Type | Individual |
| Full Name | MR. IRA RICHARD GILLUM |
| Credential | PA C |
| Practice Address |
104 S Devine Groveton TX 75845-0104 |
| Mailing Address |
Po Box 459 104 S Devine Groveton TX 75845-0459 |
| Practice Telephone | 9366420841 |
| Practice Fax Number | 9366420849 |
| Mailing Telephone | 9366420841 |
| Mailing Fax Number | 9366420849 |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA 00013 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | LICENSE | PA 00013 | 01 |
| Street Address |
104 S DEVINE |
| City | GROVETON |
| State | TX |
| Zip Code | 75845-0104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154304467 | James Michael Cochran | Family Medicine | 104 S Devine, Groveton, TX 75845-0104 | 2005-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093216343 | Berta Ruth Henderson | Licensed Practical Nurse | 434 Lakeview, Groveton, TX 75845 | 2018-02-22 |
| 1245571355 | Groveton Independent School District | Local Education Agency (LEA) | 207 N Main Street, Groveton, TX 75845 | 2013-03-14 |
| 1174759385 | Lone Star Expeditions, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1728 Forest Road 5101, Groveton, TX 75845 | 2009-06-02 |
| 1568612299 | Groveton I Enterprises, LLC | Assisted Living Facility | 1020 W 1st Street, Groveton, TX 75845 | 2008-09-30 |
| 1811178031 | Keith Edward Jones | Physician Assistant | 110 Magee Street, Groveton, TX 75845 | 2007-11-15 |
| 1376602607 | Groveton Texas Hospital Authority | Nursing Facility/Intermediate Care Facility | 1020 W 1st St, Groveton, TX 75845 | 2006-12-06 |
| 1780710681 | Groveton Texas Hospital Authority | Nursing Facility/Intermediate Care Facility | Box 890 Hwy 287 N, Groveton, TX 75845-0890 | 2007-02-26 |
| 1578063418 | Lori Loving Archambeau | Licensed Vocational Nurse | 8442 N State Highway 94, Groveton, TX 75845-2362 | 2018-02-16 |
| 1730673849 | Connie Dee Fuller | Licensed Vocational Nurse | 8442 N State Highway 94, Groveton, TX 75845-2362 | 2018-06-21 |
| 1457694465 | Centerville Isd | Local Education Agency (LEA) | 10327 N State Highway 94, Groveton, TX 75845-2651 | 2013-03-28 |
| Find all providers in zip 75845 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750364188 | Dennis Jay Clark Jr. | Physician Assistant | 110 Magee, Groveton, TX 75845-4185 | 2005-11-21 |
| 1104061431 | Lindsey Catherine Foss | Physician Assistant | 47 Church St, Groveton, NH 03582-4061 | 2008-12-16 |
| 1780867994 | Sonya Gilbert | Physician Assistant | 47 Church St, Groveton, NH 03582-4061 | 2007-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700440 | Heather Weir | Physician Assistant | 7331 Gaston Ave Ste 180, Dallas, TX 75214-4131 | 2020-11-03 |
| 1366042335 | Mary Elizabeth Arnold | Physician Assistant | 12455 Longmire Lakeview, Conroe, TX 77304-1087 | 2020-10-29 |
| 1396345443 | Avery Rhodes Schwartz | Physician Assistant | 2206 Latexo Dr, Houston, TX 77018-1717 | 2020-10-28 |
| 1174123111 | Stephanie Rae Moench | Physician Assistant | 1704 Enfield Rd Apt 102, Austin, TX 78703-3348 | 2020-10-28 |
| 1811596927 | Emily Lau | Physician Assistant | 3848 N Tarrant Pkwy Ste 120, Fort Worth, TX 76244-5422 | 2020-10-20 |
| 1720686116 | Richard Magana | Physician Assistant | 1651 Ridgemar Dr, Grand Prairie, TX 75051-3340 | 2020-10-16 |
| 1295333532 | Victoria Jane Campbell | Physician Assistant | 4412 Young Dr, Carrollton, TX 75010-1144 | 2020-10-09 |
| 1134726763 | Barbara Elizabeth Montoya | Physician Assistant | 3309 Nottingham Dr, Laredo, TX 78043-1202 | 2020-10-06 |
| 1376140400 | April L Thepsoumane | Physician Assistant | 4808 Hale Dr, Austin, TX 78749-3711 | 2020-10-01 |
| 1881291938 | Christine Nicole Nott | Physician Assistant | 13325 Hargrave Rd # 240, Houston, TX 77070-4539 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. IRA RICHARD GILLUM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.