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General NPI Number Information
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NPI Number | 1255207684
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Entity Type | Individual
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Provider Name | EAN MILLER PHARMD, BCPPS
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Gender | Male
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 801 7TH AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-2796
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Country | US
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Telephone | 682-885-3132
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 COZBY ST W
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City | BENBROOK
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State | TX
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Zip | 76126-3406
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Country | US
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Telephone |
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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 | 1835P0200X
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Taxonomy Name | Pediatric Pharmacist
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License Number | 51991
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License Number State | TX
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