Doctor Name: | JAMES KEGAN MILSTEAD |
NPI Number: | 1457748634 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 3150 Horton Rd Forest Hill, TX - 761195905 |
Business Phone Number: | 8174133451 |
Business Fax Number: | |
Mailing Address: | 3150 Horton Rd, FOREST HILL |
State: | TX |
Postal Code: | 761195905 |
Phone Number: | 8174133451 |
Fax Number: | |
NPI Enumeration Date: | 04/25/2015 |
NPI Last Update Date: | 04/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |