Healthcare Provider Details

I. General information

NPI: 1467412155
Provider Name (Legal Business Name): THOMAS MILLIGAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2006
Last Update Date: 01/29/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3533 S ALAMEDA ST
CORPUS CHRISTI TX
78411-1721
US

IV. Provider business mailing address

3533 S ALAMEDA ST
CORPUS CHRISTI TX
78411-1721
US

V. Phone/Fax

Practice location:
  • Phone: 361-694-5427
  • Fax:
Mailing address:
  • Phone: 361-694-5427
  • Fax: 361-808-2142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberG5384
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License NumberG5384
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: