Provider Demographics
NPI:1447373980
Name:W.L. GILCREASE D.D.S., INC.
Entity type:Organization
Organization Name:W.L. GILCREASE D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:W.
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:GILCREASE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-392-5549
Mailing Address - Street 1:119 W SAN ANTONIO ST
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-5510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:119 W SAN ANTONIO ST
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5510
Practice Address - Country:US
Practice Address - Phone:512-392-5549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental