Kyra Azelia McMillan

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT145875 Issued in TX

Practice address

18216 Preston Rd Ste B-3
Dallas, TX 75252-5412

Phone

(813) 856-6029

NPI assigned

Aug 19, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Revive Therapeutic Center

  • Massage Therapist
  • Dallas, TX
  • NPI 1457225161
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1063244895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 HANSELL RD APT 6313",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750244217",
            "telephone_number": "813-856-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18216 PRESTON RD STE B-3",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525412",
            "telephone_number": "813-856-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "KYRA",
        "middle_name": "AZELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA101355",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT145875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy McMillan-Maker
• Adrienne McMillan, M.D.
• David Wright McMillan, NP-C
• Elizabeth Armstrong McMillan, CRNA
• Frank Ney McMillan IV
• Margaret Rose McMillan, DDS
• Peggy A McMillan, OCCUPATIONAL THERAPI
• Shaudae McMillan
• Stacy Chase McMillan, LCSW
• Christopher A McMillian, MD

• Massage Therapist in Dallas, TX
• Providers in Dallas, TX by specialty
• Massage Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.