Healthcare Provider Details

I. General information

NPI: 1902095722
Provider Name (Legal Business Name): PAMALA R MILLER DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1024 S GREENVILLE AVE STE 130
ALLEN TX
75002-3328
US

IV. Provider business mailing address

1024 S GREENVILLE AVE STE 130
ALLEN TX
75002-3328
US

V. Phone/Fax

Practice location:
  • Phone: 972-390-2273
  • Fax:
Mailing address:
  • Phone: 972-390-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number4035
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: