Provider Demographics
NPI:1881014587
Name:MILLIKAN, KENDALL (PHARMD)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:
Last Name:MILLIKAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 CELOSIA
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-2412
Mailing Address - Country:US
Mailing Address - Phone:972-333-1831
Mailing Address - Fax:
Practice Address - Street 1:807 CELOSIA
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-2412
Practice Address - Country:US
Practice Address - Phone:972-333-1831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53377183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist