Individual provider Active NPI

Marjorie R Milici, M.D.

  • Pediatrics Physician
  • Dallas, TX
National Provider Identifier
1295765410
Registry record updated Jan 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
J0863 Issued in TX
Practice address
9101 N Central Expy
Suite 420
Dallas, TX 75231-5927
Phone
(214) 823-2525
Fax
(214) 826-0466
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X J0863 TX Primary

Addresses

Primary practice location

9101 N Central Expy
Suite 420
Dallas, TX 75231-5927

Mailing address

9101 N Central Expy
Suite 420
Dallas, TX 75231-5927
Phone (214) 823-2525

Other identifiers 1

IdentifierTypeStateIssuer
119109002MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180116002608 TX Practitioner - Pediatric Medicine 3476812694 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J0863TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Pediatrics CurrentSince Jan 5, 2018 Accepting new patients
Healthtexas Provider Network CurrentSince Jan 5, 2018 Accepting new patients

Locations

9101 N Central Expy
Ste 420
Dallas, TX 75231
Phone (214) 820-8220

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231200000000",
    "number": "1295765410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 N CENTRAL EXPY",
            "address_2": "SUITE 420",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315927",
            "telephone_number": "214-823-2525",
            "fax_number": "214-826-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 N CENTRAL EXPY",
            "address_2": "SUITE 420",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315927",
            "telephone_number": "214-823-2525",
            "fax_number": "214-826-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILICI",
        "first_name": "MARJORIE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2009-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J0863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119109002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.