Provider Demographics
NPI:1215196506
Name:MILBERGER, KYLE ANTHONY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:ANTHONY
Last Name:MILBERGER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16731 COIT RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1750
Mailing Address - Country:US
Mailing Address - Phone:214-775-0207
Mailing Address - Fax:
Practice Address - Street 1:16731 COIT RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1750
Practice Address - Country:US
Practice Address - Phone:214-775-0207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007009183500000X
TX50049183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist