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General NPI Number Information
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NPI Number | 1295765410
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Entity Type | Individual
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Provider Name | MARJORIE R MILICI M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 01/06/2009
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Provider Practice Location Address
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Address Line | 9101 N CENTRAL EXPY SUITE 420
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City | DALLAS
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State | TX
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Zip | 75231-5927
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Country | US
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Telephone | 214-823-2525
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Fax | 214-826-0466
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Provider Business Mailing Address
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Address Line | 9101 N CENTRAL EXPY SUITE 420
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City | DALLAS
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State | TX
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Zip | 75231-5927
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Country | US
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Telephone | 214-823-2525
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Fax | 214-826-0466
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | J0863
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License Number State | TX
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