Provider Demographics
NPI:1063576015
Name:MILLAN, XIMENA (MD)
Entity type:Individual
Prefix:DR
First Name:XIMENA
Middle Name:
Last Name:MILLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 BIRCH CANOE DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-1484
Mailing Address - Country:US
Mailing Address - Phone:832-316-1866
Mailing Address - Fax:832-426-7698
Practice Address - Street 1:800 PEAKWOOD DR
Practice Address - Street 2:SUITE 3A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2900
Practice Address - Country:US
Practice Address - Phone:281-587-8777
Practice Address - Fax:281-587-2577
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242130207R00000X
TXN3890207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02823325Medicaid