Individual
JERRAD SCOTT MILLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2009 CENTER ST, DEER PARK, TX 77536-4161
(281) 479-4570
(281) 479-7895
Mailing address
2009 CENTER ST, DEER PARK, TX 77536-4161
(281) 479-4570
(281) 479-7895
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6368TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0042PP
BLUE CROSS BLUE SHIELD
TX
01
—
81990Q
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/31/2005
Last updated
01/31/2011
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