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General NPI Number Information
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NPI Number | 1588676449
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Entity Type | Individual
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Provider Name | GREGORY JAMES MILLER PA-C, MPAS
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Gender | Male
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 9330 CORPORATE DRIVE OLYMPIA II BUSINESS SUITE #804
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City | SELMA
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State | TX
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Zip | 78154-1258
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Country | US
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Telephone | 830-572-5738
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Fax | 210-756-6189
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Provider Business Mailing Address
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Address Line | 9330 CORPORATE DRIVE OLYMPIA II BUSINESS SUITE #804
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City | SELMA
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State | TX
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Zip | 78154-1258
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Country | US
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Telephone | 830-572-5738
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Fax | 210-756-6189
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1055
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA1055
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA02238
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA10005152
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License Number State | WA
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Taxonomy #6
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA02238
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License Number State | TX
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