Healthcare Provider Details

I. General information

NPI: 1396679734
Provider Name (Legal Business Name): DESTINY MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 FM 2920 RD
SPRING TX
77388-3412
US

IV. Provider business mailing address

21145 SPRING PLAZA DR APT 4110
SPRING TX
77388-1447
US

V. Phone/Fax

Practice location:
  • Phone: 281-907-7950
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: