Individual
MILTON GAYLE MULLANAX
Active
Individual
MILTON GAYLE MULLANAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
D1750
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072055635
TEXAS RR MEDICARE
TX
01
—
4325609
AETNA PROVIDER NUMBER
TX
01
—
86620X
BCBS
TX
Enumeration date
01/26/2007
Last updated
08/07/2008
Update your record
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