Provider Demographics
NPI:1972676633
Name:MILLS, VIRGINIA M
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:M
Last Name:MILLS
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:VIRGINIA
Other - Middle Name:M
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:11023 NORTHPOINTE BLVD
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-2433
Mailing Address - Country:US
Mailing Address - Phone:281-919-2190
Mailing Address - Fax:877-288-1193
Practice Address - Street 1:11023 NORTHPOINTE BLVD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-2433
Practice Address - Country:US
Practice Address - Phone:281-919-2190
Practice Address - Fax:877-288-1193
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2210207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F87405Medicare UPIN