MEDICARE: JAMIE L MILES D.C.

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	111N00000X	Chiropractor	8718	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC8718	OTHER	TX	WORKERS COMP
2	8U7930	OTHER	TX	BCBS
3	470947661	OTHER	TX	TAX ID
4	7127260	OTHER	TX	AETNA INSURANCE

General Provider Information

NPI Number	:	1841213816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE L MILES D.C.

Provider Business Mailing Address
First Line	:	3027 MARINA BAY DR
Second Line	:	STE 105
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-2772
Country	:	US
Telephone Number	:	281-538-2062
Fax Number	:	281-538-6309

Provider Business Practice Location Address
First Line	:	3027 MARINA BAY DR
Second Line	:	STE 105
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-2772
Country	:	US
Telephone Number	:	281-538-2062
Fax Number	:	281-538-1046

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	10/30/2019

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