Healthcare Provider Details

I. General information

NPI: 1063385243
Provider Name (Legal Business Name): SHAYLON MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5757 WARREN PKWY STE 200
FRISCO TX
75034-4777
US

IV. Provider business mailing address

5757 WARREN PKWY STE 200
FRISCO TX
75034-4777
US

V. Phone/Fax

Practice location:
  • Phone: 972-777-3232
  • Fax: 972-777-3131
Mailing address:
  • Phone: 972-777-3232
  • Fax: 972-777-3131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1213224
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1213224
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: