Healthcare Provider Details

I. General information

NPI: 1992156855
Provider Name (Legal Business Name): MORGAN MILLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2016
Last Update Date: 03/24/2023
Certification Date: 03/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 S BUCKNER BLVD STE 141
DALLAS TX
75217-1794
US

IV. Provider business mailing address

PO BOX 321359
FLOWOOD MS
39232-1359
US

V. Phone/Fax

Practice location:
  • Phone: 214-305-7065
  • Fax:
Mailing address:
  • Phone: 601-933-6593
  • Fax: 601-933-6596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number26352
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberU0922
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: