Individual
EDGAR MILAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1901 SW H K DODGEN LOOP, TEMPLE, TX 76502-1814
(254) 935-4000
(254) 935-4111
Mailing address
P.O. BOX 844658, DALLAS, TN 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
65047
TX
367500000X
Certified Registered Nurse Anesthetist
RN65047
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4134284
BC
TN
Enumeration date
06/28/2006
Last updated
09/07/2017
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