1821383340 NPI number — MS. GINGER LEE ANNE MILLIS RPH

Table of content: MS. GINGER LEE ANNE MILLIS RPH (NPI 1821383340)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821383340 NPI number — MS. GINGER LEE ANNE MILLIS RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLIS
Provider First Name:
GINGER
Provider Middle Name:
LEE ANNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821383340
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8900 STATE HIGHWAY 121
Provider Second Line Business Mailing Address:
T-2142
Provider Business Mailing Address City Name:
MCKINNEY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75070-2917
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-439-3398
Provider Business Mailing Address Fax Number:
972-439-3398

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8900 STATE HIGHWAY 121
Provider Second Line Business Practice Location Address:
T-2142
Provider Business Practice Location Address City Name:
MCKINNEY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75070-2917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-439-3398
Provider Business Practice Location Address Fax Number:
972-439-3398
Provider Enumeration Date:
06/13/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  36457 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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