MEDICARE: DRS MILBURN-PLANO LLC

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1316550411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRS MILBURN-PLANO LLC

Provider Business Mailing Address
First Line	:	4160 W SPRING CREEK PKWY
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-5316
Country	:	US
Telephone Number	:	972-612-2099
Fax Number	:

Provider Business Practice Location Address
First Line	:	4160 W SPRING CREEK PKWY STE 100
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-5317
Country	:	US
Telephone Number	:	330-416-4569
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TIM MILBURN
Credential	:	O.D.
Telephone Number	:	330-416-4569

Provider Enumeration Date	:	08/28/2020
Last Update Date	:	10/20/2023

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Directions to “DRS MILBURN-PLANO LLC ” Practice Location

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