Healthcare Provider Details

I. General information

NPI: 1326835992
Provider Name (Legal Business Name): JAMES MILLER JR. CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2025
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 OLYMPUS BLVD STE 500
COPPELL TX
75019-1205
US

IV. Provider business mailing address

9925 OSPREY DR
FORT WORTH TX
76108-4332
US

V. Phone/Fax

Practice location:
  • Phone: 866-871-8519
  • Fax:
Mailing address:
  • Phone: 916-235-0350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number026.0155636
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number101.0138355
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: