Provider Demographics
NPI:1871558718
Name:ZILINSKAS, GWENDOLYN BROOKE (MMS, PA-C)
Entity type:Individual
Prefix:MS
First Name:GWENDOLYN
Middle Name:BROOKE
Last Name:ZILINSKAS
Suffix:
Gender:F
Credentials:MMS, PA-C
Other - Prefix:MS
Other - First Name:GWENDOLYN
Other - Middle Name:BROOKE
Other - Last Name:WHITNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MMS, PA-C
Mailing Address - Street 1:109 BERKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:TX
Mailing Address - Zip Code:75032
Mailing Address - Country:US
Mailing Address - Phone:630-728-8329
Mailing Address - Fax:
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9110
Practice Address - Country:US
Practice Address - Phone:214-645-8765
Practice Address - Fax:214-645-8769
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06501363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant