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General NPI Number Information
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NPI Number | 1467581439
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Entity Type | Organization
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Legal Business Name | JOHN DAVID MILLER, M.D.P.A.
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 12/28/2009
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Provider Practice Location Address
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Address Line | 1615 HOSPITAL PKWY SUITE 306
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City | BEDFORD
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State | TX
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Zip | 76022-5934
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Country | US
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Telephone | 817-684-5106
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Fax | 817-684-5120
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Provider Business Mailing Address
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Address Line | 1615 HOSPITAL PKWY SUITE 306
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City | BEDFORD
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State | TX
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Zip | 76022-5934
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Country | US
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Telephone | 817-684-5106
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Fax | 817-684-5120
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN DAVID MILLER
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Credential | M.D.
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Telephone | 817-684-5106
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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 | D7189
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License Number State | TX
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