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NPI Code Detail

MEDICARE: JONATHAN MILLER

MEDICARE:   JONATHAN  MILLER
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
13336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1457938482
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN MILLER
Provider Business Mailing Address
First Line : 1224 ELM RIDGE LN
Second Line :
City : BROWNSVILLE
State : TX
Zip : 78520-9231
Country : US
Telephone Number : 956-372-0227
Fax Number :
Provider Business Practice Location Address
First Line : 703 E HILDEBRAND AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78212-2535
Country : US
Telephone Number : 210-833-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2021
Last Update Date : 03/25/2021

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Directions to “ JONATHAN MILLER ” Practice Location

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