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NPI Code Detail

MEDICARE: MR. HAROLD DEAN MILLER MS, ATC, LAT

MEDICARE:  MR. HAROLD DEAN MILLER  MS, ATC, LAT
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
12255A2300XAthletic TrainerAT4735TX

General Provider Information

NPI Number : 1962958884
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. HAROLD DEAN MILLER MS, ATC, LAT
Provider Business Mailing Address
First Line : PO BOX 25290
Second Line :
City : HOUSTON
State : TX
Zip : 77265
Country : US
Telephone Number : 925-238-6141
Fax Number :
Provider Business Practice Location Address
First Line : 4218 CHILDRESS ST
Second Line : UNIT B
City : HOUSTON
State : TX
Zip : 77005-1014
Country : US
Telephone Number : 925-238-6141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2016
Last Update Date : 08/31/2016

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Directions to “ MR. HAROLD DEAN MILLER MS, ATC, LAT” Practice Location

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