Individual
MILLICENT ANDREA DALLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10830 HEATHER HILL DR, HOUSTON, TX 77086
(832) 704-8318
Mailing address
10830 HEATHER HILL DR, HOUSTON, TX 77086-1837
(832) 704-8318
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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