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General NPI Number Information
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NPI Number | 1861355232
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Entity Type | Individual
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Provider Name | DEREK B MILLIEAN
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Gender | Male
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 2626 S LOOP W STE 555
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City | HOUSTON
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State | TX
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Zip | 77054-2652
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Country | US
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Telephone | 888-242-3098
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Fax | 800-898-9520
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Provider Business Mailing Address
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Address Line | 2626 S LOOP W STE 555
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City | HOUSTON
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State | TX
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Zip | 77054-2652
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Country | US
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Telephone | 281-579-2409
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Fax | 800-898-9520
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 35089
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License Number State | TX
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