Basic Information
Provider Information
NPI: 1184832727
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILLAN
FirstName: LIZ
MiddleName: P
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7109 BARTLETT AVE SUTE 101
Address2:  
City: LAREDO
State: TX
PostalCode: 78041
CountryCode: US
TelephoneNumber: 9567175775
FaxNumber: 9567175875
Practice Location
Address1: 7109 BARTLETT AVE SUTE 101
Address2:  
City: LAREDO
State: TX
PostalCode: 78041
CountryCode: US
TelephoneNumber: 9567175775
FaxNumber: 9567175875
Other Information
ProviderEnumerationDate: 05/18/2007
LastUpdateDate: 06/12/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XMT189166PAN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000XN6493TXY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


Home