Healthcare Provider Details

I. General information

NPI: 1982699245
Provider Name (Legal Business Name): ROBERT IRVING MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8435 WURZBACH RD
SAN ANTONIO TX
78229-3921
US

IV. Provider business mailing address

221 3RD ST W BLDG 1040
JBSA RANDOLPH TX
78150-4800
US

V. Phone/Fax

Practice location:
  • Phone: 210-450-7334
  • Fax:
Mailing address:
  • Phone: 210-652-8544
  • Fax: 210-652-9836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35060722
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberV4712
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number35-060722
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberV4712
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: