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General NPI Number Information
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NPI Number | 1689831414
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Entity Type | Individual
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Provider Name | DANA RAY MILLS MD
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Gender | Male
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 12/15/2015
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Provider Practice Location Address
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Address Line | 2000 KELL BLVD
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City | WICHITA FALLS
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State | TX
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Zip | 76301-5528
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Country | US
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Telephone | 940-767-1738
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Fax |
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Provider Business Mailing Address
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Address Line | 4331 GLENWOOD AVE
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City | DALLAS
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State | TX
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Zip | 75205-4320
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Country | US
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Telephone | 940-767-1738
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Fax |
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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 | H2611
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License Number State | TX
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