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Individual

DR. MILTON BOYD HERNDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO PA

Contact information

Practice address
886 SIERRA DR, PORT NECHES, TX 77651-5607
(406) 729-6401
(409) 729-6015
Mailing address
886 SIERRA DR, PORT NECHES, TX 77651-5607
(406) 729-6401
(409) 729-6015

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
G9118
TX
207YS0123X
Facial Plastic Surgery Physician
Primary
G9118
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
120264005
TX
05
168285801
TX
Enumeration date
07/13/2006
Last updated
06/09/2014
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