Healthcare Provider Details

I. General information

NPI: 1639180342
Provider Name (Legal Business Name): CARMEN E LLAUGER-MIER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 11/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 SAMUELL BLVD
DALLAS TX
75228-6827
US

IV. Provider business mailing address

3102 KINGS RD APT 2106
DALLAS TX
75219-1326
US

V. Phone/Fax

Practice location:
  • Phone: 214-381-7181
  • Fax:
Mailing address:
  • Phone: 210-857-6454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberJ0990
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: