Provider Demographics
NPI:1235334004
Name:J T MILLS D M D
Entity Type:Organization
Organization Name:J T MILLS D M D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:TRACY
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-556-1606
Mailing Address - Street 1:1011 HIGHWAY 6 S STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-1040
Mailing Address - Country:US
Mailing Address - Phone:281-556-1606
Mailing Address - Fax:281-556-1438
Practice Address - Street 1:1011 HIGHWAY 6 S STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1040
Practice Address - Country:US
Practice Address - Phone:281-556-1606
Practice Address - Fax:281-556-1438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental