Provider Demographics
NPI:1659839819
Name:DR MILTON HEALTH CENTER
Entity Type:Organization
Organization Name:DR MILTON HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:
Authorized Official - Last Name:ENCARNACION QUEZADA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:682-238-3801
Mailing Address - Street 1:912 W RANDOL MILL RD STE A
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-2564
Mailing Address - Country:US
Mailing Address - Phone:682-238-3801
Mailing Address - Fax:
Practice Address - Street 1:912 W RANDOL MILL RD STE A
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2564
Practice Address - Country:US
Practice Address - Phone:682-238-3801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty