Healthcare Provider Details

I. General information

NPI: 1659839819
Provider Name (Legal Business Name): DR MILTON HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2019
Last Update Date: 03/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 W RANDOL MILL RD STE A
ARLINGTON TX
76012-2564
US

IV. Provider business mailing address

912 W RANDOL MILL RD STE A
ARLINGTON TX
76012-2564
US

V. Phone/Fax

Practice location:
  • Phone: 682-238-3801
  • Fax:
Mailing address:
  • Phone: 682-238-3801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: MILTON ENCARNACION QUEZADA
Title or Position: DIRECTOR
Credential: DC
Phone: 682-238-3801