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General NPI Number Information
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NPI Number | 1346144235
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Entity Type | Organization
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Legal Business Name | LOA3, LLC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 9355 JOHN W ELLIOT DR SUITE 25 #25645
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City | FRISCO
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State | TX
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Zip | 75033
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Country | US
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Telephone | 847-624-0386
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Fax |
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Provider Business Mailing Address
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Address Line | 9355 JOHN W ELLIOT DR SUITE 25 #25645
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City | FRISCO
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State | TX
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Zip | 75033
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Country | US
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Telephone | 847-624-0386
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. CHRIS ROBERT MILLER
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Credential | MD
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Telephone | 847-624-0386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State | NULL
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