Basic Information
Provider Information
NPI: 1245242189
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILHOAN
FirstName: KIRK
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: M.D., PH.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7703 FLOYD CURL DR
Address2: MC 7977
City: SAN ANTONIO
State: TX
PostalCode: 782293901
CountryCode: US
TelephoneNumber: 2102571400
FaxNumber: 2102571428
Practice Location
Address1: 7703 FLOYD CURL DR
Address2: MC 7977
City: SAN ANTONIO
State: TX
PostalCode: 782293901
CountryCode: US
TelephoneNumber: 2102571400
FaxNumber: 2102571428
Other Information
ProviderEnumerationDate: 08/12/2006
LastUpdateDate: 06/06/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0202XM2715TXY Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology

ID Information
IDTypeStateIssuerDescription
17282550105TX MEDICAID


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