GEOFFREY M MILLICAN MD PA
Medical Practice at Booth Calloway Rd, Fort Worth, TX

License number
Texas M3024
Category
Medical Practice
Type
Sports Medicine
Owner
Name: GEOFFREY M MILLICAN M.D.
Title: DOCTOR-OWNER
Phone: (817) 616-0700
Address
Address
4375 Booth Calloway Rd STE 400, Fort Worth, TX 76180
National Provider ID: 1922194166
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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GEOFFREY M. MILLICAN, M.D., PA

San Antonio, TX  -  Fort Worth, TX  -  Dallas, TX

Doing business as:
Geoffrey M. Millican, M.D., PA
Registration:
Mar 14, 2006
Addresses:
227 Stanford Dr, San Antonio, TX 78212 (Mailing)
4375 Booth Calloway Rd, Fort Worth, TX 76180
PO Box 180309, Dallas, TX 75218
State ID:
0800627290
Business type:
Professional Association
President, Director, Member:
Geoffrey Means Millican (President, Director, Member)
Agent:
Geoffrey M Millican,7940 Floyd Curl Dr STE 560, San Antonio, TX 78229 (Physical)
TIN:
32035212789

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