Healthcare Provider Details

I. General information

NPI: 1487650578
Provider Name (Legal Business Name): REAGAN B MCMILLIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 VETERANS DR
HARLINGEN TX
78550-8942
US

IV. Provider business mailing address

3105 LEON CIR
HARLINGEN TX
78550-8640
US

V. Phone/Fax

Practice location:
  • Phone: 956-291-9233
  • Fax:
Mailing address:
  • Phone: 956-425-8815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License NumberH8753
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberH8753
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: