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General NPI Number Information
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NPI Number | 1407861073
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Entity Type | Organization
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Legal Business Name | BRET H MILLER MD PA ORTHOPAEDIC AND SPORTS MEDICINE SPECIALISTS OF WAC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 300 RICHLAND WEST CIR SUITE 1
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City | WACO
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State | TX
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Zip | 76712-7934
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Country | US
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Telephone | 254-772-8677
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Fax | 254-752-1511
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Provider Business Mailing Address
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Address Line | PO BOX 21506
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City | WACO
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State | TX
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Zip | 76702-1506
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Country | US
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Telephone | 254-772-8677
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Fax | 254-752-1511
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Authorized Official
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Title or Position | MEDICAL PRACTICE ADMINISTRATOR
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Name | ANDREW B SZANTO
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Credential |
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Telephone | 254-772-8677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | H2608
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License Number State | TX
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