Mary Milam, M.D., P.a.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

E4529 Issued in TX

Legal business name

MARY MILAM, M.D., P.A.

Practice address

1307 8TH Ave
Suite 205
Fort Worth, TX 76104-4137

Phone

(817) 924-4300

Fax

(817) 924-1493

NPI assigned

Jul 2, 2008

Organization subpart

No

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

Authorized official

Name

Mary Milam, M.D., P.ANPI 1063415735

Title

Owner

Phone

(817) 924-4300

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Milam, MD

  • Hematology & Oncology Physician
  • Fort Worth, TX
  • NPI 1063415735
  Medicare reassignment NPD Authorized official
• Catherine A Colquitt, MD

  • Infectious Disease Physician
  • Fort Worth, TX
  • NPI 1275533846
  NPD (past)

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1174786933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 8TH AVE",
            "address_2": "SUITE 205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044137",
            "telephone_number": "817-924-4300",
            "fax_number": "817-924-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 8TH AVE",
            "address_2": "SUITE 205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044137",
            "telephone_number": "817-924-4300",
            "fax_number": "817-924-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY MILAM, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "MILAM",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-924-4300",
        "authorized_official_credential": "M.D., P.A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "E4529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135615604",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew L Marvin, RN
• David M Marvin, MD
• Katherine Anne Marx, CRNA
• Mary Dainty, M.a., LPC-S
• Mary M Carter
• Mas Monitoring LLC
• Masa Neuromonitoring PLLC
• Sabbina M Masando
• Tyler Masden, MD
• Evan Charles Mashigian

• Hematology & Oncology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Hematology & Oncology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.