Healthcare Provider Details
I. General information
NPI: 1063879161
Provider Name (Legal Business Name): THE GIFT ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/20/2016
Last Update Date: 04/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7525 JOHN T WHITE RD
FORT WORTH TX
76120-3311
US
IV. Provider business mailing address
PO BOX 1953
ARLINGTON TX
76004-1953
US
V. Phone/Fax
- Phone: 817-338-9553
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DENNIS
R
MILLER
Title or Position: OWNER
Credential: PH.D.
Phone: 817-338-9553