Provider Demographics
NPI:1508890914
Name:CLUFF, DOUGLAS MILLET (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:MILLET
Last Name:CLUFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W IH 635 FWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3718
Mailing Address - Country:US
Mailing Address - Phone:972-869-2772
Mailing Address - Fax:972-869-1747
Practice Address - Street 1:400 W IH 635 FWY
Practice Address - Street 2:SUITE 210
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-3718
Practice Address - Country:US
Practice Address - Phone:972-869-2772
Practice Address - Fax:972-869-1747
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1822207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B4360OtherBCBS
TX149129201Medicaid
H49636Medicare UPIN
TX149129201Medicaid
TX8735J9Medicare PIN