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NPI 1407660806

NPI 1407660806 : COREY MILLER DC : AUSTIN, TX

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General NPI Number Information
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    NPI Number           |    1407660806
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    Entity Type          |    Individual 
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    Provider Name        |    COREY MILLER DC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/05/2025
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    Last Update Date     |    02/05/2025
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Provider Practice Location Address
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    Address Line         |    13341 W US HIGHWAY 290 STE 102 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78737-9160
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    Country              |    US
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    Telephone            |    512-899-2228
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    Fax                  |    512-899-2226
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Provider Business Mailing Address
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    Address Line         |    4601 SOUTHWEST PKWY STE 101 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78735-8939
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    Country              |    US
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    Telephone            |    512-899-2228
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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        |    111NN1001X
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    Taxonomy Name        |    Nutrition Chiropractor
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    License Number       |    16341
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    License Number State |    TX
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Taxonomy #2
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    Taxonomy Code        |    111NP0017X
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    Taxonomy Name        |    Pediatric Chiropractor
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    License Number       |    16341
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    License Number State |    TX
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Taxonomy #3
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    Taxonomy Code        |    111NR0400X
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    Taxonomy Name        |    Rehabilitation Chiropractor
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    License Number       |    16341
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    License Number State |    TX
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Taxonomy #4
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    Taxonomy Code        |    111NS0005X
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    Taxonomy Name        |    Sports Physician Chiropractor
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    License Number       |    16341
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    License Number State |    TX
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Taxonomy #5
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    16341
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    License Number State |    TX
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