Provider Demographics
NPI:1124996483
Name:MCMILLIN, JAKE CURRY
Entity type:Individual
Prefix:
First Name:JAKE
Middle Name:CURRY
Last Name:MCMILLIN
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 1:5319 30TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3515
Mailing Address - Country:US
Mailing Address - Phone:806-561-1340
Mailing Address - Fax:806-507-6323
Practice Address - Street 1:2600 LOCKWOOD ST
Practice Address - Street 2:
Practice Address - City:TAHOKA
Practice Address - State:TX
Practice Address - Zip Code:79373-4118
Practice Address - Country:US
Practice Address - Phone:806-561-1340
Practice Address - Fax:806-507-1340
Is Sole Proprietor?:No
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1367039225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist