Provider Demographics
NPI:1710358130
Name:MILLEN, CASEY
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:MILLEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 LEGACY DR
Mailing Address - Street 2:SUITE 494
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3100
Mailing Address - Country:US
Mailing Address - Phone:972-591-5935
Mailing Address - Fax:469-453-3004
Practice Address - Street 1:5000 LEGACY DR
Practice Address - Street 2:SUITE 494
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3100
Practice Address - Country:US
Practice Address - Phone:972-591-5935
Practice Address - Fax:469-453-3004
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic