Individual
RUSTY ALLEN MILHOAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3150 MATLOCK RD, SUITE 401, ARLINGTON, TX 76015-2992
(817) 375-9790
(817) 375-9791
Mailing address
3150 MATLOCK RD, SUITE 401, ARLINGTON, TX 76015-2992
(817) 375-9790
(817) 375-9791
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H1303
TX
208600000X
Surgery Physician
H1303
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139964401
—
TX
01
—
161676686
TRICARE
TX
01
—
2319377
BLUECROSSBLUESHIELD
TX
01
—
5700162
AETNA
TX
Enumeration date
03/03/2006
Last updated
02/02/2022
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