Provider Demographics
NPI:1912568999
Name:MILLARD EMERGENCY PHYSICIANS, PLLC
Entity Type:Organization
Organization Name:MILLARD EMERGENCY PHYSICIANS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CASTANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-506-8503
Mailing Address - Street 1:14404 STONEY BROOK BLVD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2613
Mailing Address - Country:US
Mailing Address - Phone:402-979-9635
Mailing Address - Fax:
Practice Address - Street 1:14404 STONEY BROOK BLVD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2613
Practice Address - Country:US
Practice Address - Phone:402-979-9635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No282N00000XHospitalsGeneral Acute Care HospitalGroup - Multi-Specialty