Provider Demographics
NPI:1609272178
Name:MILTON, RAVIN M (PHARMD, RHIA)
Entity type:Individual
Prefix:DR
First Name:RAVIN
Middle Name:M
Last Name:MILTON
Suffix:
Gender:F
Credentials:PHARMD, RHIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 S RIDGEWAY DR # 1011
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-4611
Mailing Address - Country:US
Mailing Address - Phone:817-374-8642
Mailing Address - Fax:
Practice Address - Street 1:114 S OLD BETSY RD
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:TX
Practice Address - Zip Code:76059-2425
Practice Address - Country:US
Practice Address - Phone:985-703-2552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-11
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16945183500000X
TX41112183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist