MEDICARE: DR. LARRY KENNETH MILNER M.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	D9572	TX

General Provider Information

NPI Number	:	1285629725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY KENNETH MILNER M.D., P.A.

Provider Business Mailing Address
First Line	:	6243 FAIRMONT PKWY
Second Line	:	SUITE 202
City	:	PASADENA
State	:	TX
Zip	:	77505-4045
Country	:	US
Telephone Number	:	281-991-6400
Fax Number	:	281-991-6405

Provider Business Practice Location Address
First Line	:	6243 FAIRMONT PKWY
Second Line	:	SUITE 202
City	:	PASADENA
State	:	TX
Zip	:	77505-4045
Country	:	US
Telephone Number	:	281-991-6400
Fax Number	:	281-991-6405

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	05/03/2013

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