MEDICARE: KIMBERLY ANN MILLER DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT011755	GA
2	225100000X	Physical Therapist	1313641	TX

General Provider Information

NPI Number	:	1316343684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY ANN MILLER DPT

Provider Business Mailing Address
First Line	:	8323 SOUTHWEST FWY STE 101
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-1636
Country	:	US
Telephone Number	:	713-772-1400
Fax Number	:	713-772-7116

Provider Business Practice Location Address
First Line	:	8323 SOUTHWEST FWY STE 101
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-1636
Country	:	US
Telephone Number	:	713-772-1400
Fax Number	:	713-772-7116

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2014
Last Update Date	:	12/10/2018

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