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General NPI Number Information
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NPI Number | 1184448110
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Entity Type | Individual
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Provider Name | MRS. MARQUETTE YVLONDA MILLER
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Gender | Female
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Dates
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Enumeration Date | 11/15/2024
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 539 W COMMERCE ST # 1541
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City | DALLAS
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State | TX
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Zip | 75208-1953
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Country | US
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Telephone | 469-535-1275
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Fax |
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Provider Business Mailing Address
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Address Line | 6351 OAKMONT BLVD STE 107
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City | FORT WORTH
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State | TX
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Zip | 76132-2814
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Country | US
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Telephone | 469-535-1275
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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