Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | H1899 | TX |
Y | 111NI0900X | Internist | H1899 | TX |
N | 207SG0201X | Clinical Genetics (M.D.) | H1899 | TX |
NPI | 1366460628 |
---|---|
Provider Name | Dianna M Milewicz |
First Address | Dallas, TX 75303-1173 |
Second Address | Houston, TX 77030-3000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 19/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
132790006 | (05) | TX |
132790007 | (05) | TX |
89Y460 | BCBS (01) | TX |
F27897 | (02) | TX |