Individual
MILTON GAYLE MULLANAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
715 N FIELDER RD, ARLINGTON, TX 76012-4695
(817) 261-1626
Mailing address
715 N FIELDER RD, ARLINGTON, TX 76012-4695
(817) 261-1626
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
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