Provider Demographics
NPI:1740384098
Name:MILES, JANE (MD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JASNA
Other - Middle Name:
Other - Last Name:MILOVANOVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 795665
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75379-5665
Mailing Address - Country:US
Mailing Address - Phone:972-934-9438
Mailing Address - Fax:214-432-5718
Practice Address - Street 1:5440 HARVEST HILL RD
Practice Address - Street 2:SUITE 212
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1607
Practice Address - Country:US
Practice Address - Phone:972-934-9438
Practice Address - Fax:214-432-5718
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL93632084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
I32159Medicare UPIN