Healthcare Provider Details

I. General information

NPI: 1316132681
Provider Name (Legal Business Name): MR. YVES MAURICE MILORD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 09/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3037 DOROTHY LN
GLENN HEIGHTS TX
75154-3861
US

IV. Provider business mailing address

3037 DOROTHY LN
GLENN HEIGHTS TX
75154-3861
US

V. Phone/Fax

Practice location:
  • Phone: 469-583-8189
  • Fax:
Mailing address:
  • Phone: 469-583-8189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number120876
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: