NPIMap

Organization Active NPI

Millennium OB GYN of Texoma PLLC

  • Obstetrics & Gynecology Physician
  • Denison, TX
National Provider Identifier
1588322218
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MILLENNIUM OB GYN OF TEXOMA PLLC
Practice address
5016 S US Highway 75
Denison, TX 75020-4584
Phone
(855) 222-9637
NPI assigned
Nov 30, 2021
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Emily Rattray
Title
Manager
Phone
(855) 222-9637

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

5016 S US Highway 75
Denison, TX 75020-4584

Mailing address

PO Box 20236
Beaumont, TX 77720-0236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220106000240 TX Part B Supplier - Clinic/Group Practice 4789075482 Receives reassigned benefits from 4 practitioners
Practice locations: Denison, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1588322218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20236",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777200236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5016 S US HIGHWAY 75",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750204584",
            "telephone_number": "855-222-9637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM OB GYN OF TEXOMA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-30",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "RATTRAY",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "855-222-9637"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.