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General NPI Number Information
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NPI Number | 1194026468
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Entity Type | Organization
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Legal Business Name | C. ANNE MILLER O.D., P.C.
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Dates
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Enumeration Date | 11/03/2010
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Last Update Date | 11/03/2010
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Provider Practice Location Address
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Address Line | 13201 N FM 620 SUITE 127
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City | AUSTIN
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State | TX
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Zip | 78717-1011
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Country | US
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Telephone | 512-335-2077
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Fax | 512-335-2811
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Provider Business Mailing Address
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Address Line | 101 SHORTHORN ST
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City | CEDAR PARK
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State | TX
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Zip | 78613-7770
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Country | US
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Telephone | 512-507-4674
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. C. ANNE MILLER
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Credential | O.D.
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Telephone | 512-335-2077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5943TG
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License Number State | TX
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