Healthcare Provider Details

I. General information

NPI: 1871556480
Provider Name (Legal Business Name): ALLEN L. MILEWICZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6624 FANNIN ST STE 1590
HOUSTON TX
77030-2312
US

IV. Provider business mailing address

2 GREENWAY PLAZA SUITE 910
HOUSTON TX
77046
US

V. Phone/Fax

Practice location:
  • Phone: 713-796-2327
  • Fax: 713-796-0397
Mailing address:
  • Phone: 713-798-1750
  • Fax: 713-798-1144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberH1900
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: