Basic Information
| Provider Information | |||||||||
| NPI: | 1700085859 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILLS | ||||||||
| FirstName: | ALICIA | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3066 E COMMERCE ST | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782201013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102337000 | ||||||||
| FaxNumber: | 2106255689 | ||||||||
| Practice Location | |||||||||
| Address1: | 1925 WEST HIGHWAY 85 | ||||||||
| Address2: | SOUTH TEXAS FAMILY RESIDENTIAL CENTER | ||||||||
| City: | DILLEY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8303786670 | ||||||||
| FaxNumber: | 8303786593 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2007 | ||||||||
| LastUpdateDate: | 12/03/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 35.089897 | OH | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | FM0303040 | 01 | OH | DEA | OTHER |